da Vinci Xi and exVive3D: Robotic Surgery and 3D Printing Analysis

This report provides a detailed analysis of two key pieces of biomedical engineering equipment: the da Vinci Xi robotic surgery system and the exVive3D kidney tissue 3D bioprinting system. The report begins with an overview of the da Vinci Xi system, including its features, components, and technical specifications, along with common problems such as device malfunction. It also identifies Intuitive Surgical as the manufacturer and discusses warranty and maintenance costs. The report then shifts to the exVive3D system, detailing its function in 3D bioprinting of tissues, manufacturer (Organovo), warranty details, and common issues like stringing and overheating. The report also lists companies that repair or sell parts for both pieces of equipment, such as Vittuki Technologies, Accuray, L’Oréal, and Merck. Finally, the report includes several references to research papers and publications related to the da Vinci Xi system and 3D printing in biomedical applications.

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Robotic Surgery Equipment: da Vinci Xi System
Figure 1: Standard da Vinci Xi System
The da Vinci Xi System comes as the fourth generation among the Intuitive’s surgical system
that enables surgeons to carry out procedure that are minimally invasive with the aid of hand
controls from computer system that is located numerous feet away from the patient undergoing
the surgery1. The later model of this system has thinner arms which are able to reach numerous
incision sites as well as lower the chances of interferences of surgical arms with each other.
1 Lamb, B. W., O. Alghazo, J. Goad, E. Upton, J. Hiller, N. Lawrentschuk, and D. Murphy. "The da Vinci© Xi
surgical system with integrated Table Motion can reduce the need for Trendelenburg position without compromising
surgical parameters." (2018)

Figure 2: Three components of da Vinci Xi System
Figure 3: da Vinci Xi System control overview
The aim of the design of this equipment is to conserve the benefit to patient undergoing
endoscopic surgery skills even as it gives back to surgeon’s dexterity of open surgery. The serial
operators which are run by the surgeon serve as device for high resolution input. Two
independent vision channels are available that send images to the surgeon with the virtual image

plane being located right above the hands2. The position of the endoscope are easily controlled
with the aid of switches and foot-actioned buttons which allow for repositioning of the master as
well as making adjustments to the focus of the camera.
2 Kim, Da Hee, Hwan Kim, Sanghyun Kwak, Kwangha Baek, Gina Na, Ji Hoon Kim, and Se Heon Kim. "The
settings, pros and cons of the new surgical robot da Vinci Xi system for transoral robotic surgery (TORS): a
comparison with the popular da Vinci Si system." Surgical laparoscopy, endoscopy & percutaneous techniques 26,
no. 5 (2016): 391-396

Figure 3: da Vinci Xi System technical specification

Manufacturer’s End of Service
The manufacturer of the device is Intuitive Surgical which is an American based company.
Intuitive Surgical provides a warranty for one year within which they provide free maintenance
services to the da Vinci Xi System sold out to various buyers. After the first year of warranty is
over, a fee of US $ 175,000 is charged annually for maintenance purposes3.
Most common problems of the device
Device malfunction: In as much as this risk tends to be rare, there are times when da Vinci Xi
equipment might malfunction and thereby resulting in devastating problems during the period of
surgery4. In such rare situations, the surgeons must quickly carry out another kind of operation to
correct the mess and have the original issue fixed. Such common problems include:
 Problems with the master tool-manipulator device
 Failure of the fused illuminator bulb
 double vision on the console
 Locked robotic arms
Other companies that repair or sell parts of the equipment include:
 Vittuki Technologies: Vittuki Technologies held the fourth-driving situation after a $275
million securing of Blue Belt Technologies in 2015. Right now, and Vittuki Technologies
3 Petro, Clayton C., and Yuri W. Novitsky. "Robotic Component Separation." In Laparoscopic and Robotic
Incisional Hernia Repair, pp. 129-140. Springer, Cham, 2018
4 Niclauss, Nadja, Philippe Morel, Minoa K. Jung, and Monika E. Hagen. "A comparison of the da Vinci Xi vs. the
da Vinci Si Surgical System for Roux-En-Y gastric bypass." Langenbeck's archives of surgery 404, no. 5 (2019):
615-620

picked up the NAVIO™ stage, which takes into account automated helped careful
unicondylar or halfway knee substitutions. This framework consolidates a handheld
instrument with a route stage so as to furnish the specialist with a victual cutting aide for
arthroscopy techniques.
 This company deals in sale of surgeon console with the sale price of a piece of the
equipment being $200,000 and takes 14 days for a delivery of an order
 Accuray: Accuray was the third-driving contender, offering their CyberKnife®
mechanical radiosurgery framework. The CyberKnife® has been created because of the
organization's association with KUKA AG, a producer of mechanical robots5. The
framework utilizes picture direction and PC controlled mechanical autonomy to convey
high-vitality radiation to a tumor, and is intended for the treatment of various kinds of
malignant growths and tumors all through the body via consequently following the
tumor's position and distinguishing any patient development to convey treatment with
sub-millimeter precision.
 This company deals in sale of patient-side cart with the sale price of a piece of the
equipment being $184,000 and takes 14 days for a delivery of an order
3D Printing Equipment: exVive3D™ Kidney Tissue
3D bioprinting defines an automated fabrication of various multicellular tissues through
deposition of cells that is spatially defined. The ability of spatially controlling deposition within
5 Hagen, Monika E., Minoa K. Jung, Frederic Ris, Jassim Fakhro, Nicolas C. Buchs, Leo Buehler, and Philippe
Morel. "Early clinical experience with the da Vinci Xi Surgical System in general surgery." Journal of robotic
surgery 11, no. 3 (2017): 347-353

the x, y and z axes enable creation of patterns or even compartments of tissues having in vivo-
like outline which copy major features of native biology6.
Figure: exVive3D™ Kidney Tissue architecture for 3D Bio printed Human Liver Tissue having
distinct hepatocellular & non-parenchymal compartments of cells
Manufacturer’s End of Service
exVive3D™ Kidney Tissue has been developed by Organovo, a company located in San Diego
California to be used by companies in drug trials as well as modelling of diseases and it seems
this use of the equipment for the specific tasks was planned to begin somewhere in mid-2016.
The manufacture offers a warranty of 2 years within which they provide free maintenance
services to the exVive3D™ Kidney Tissue sold out to various buyers. After the first year of
warranty is over, a fee of US $ 7,500 is charged annually for maintenance purposes7.
6 Rifat, U. N., and M. Rifat. "3D Printing in Urology, The Current Position, And the Future: Review Article." J Urol
Ren Dis: JURD-164. DOI 10 (2017): 2575-7903
7 Ozben, Volkan, Turgut B. Cengiz, Deniz Atasoy, Onur Bayraktar, Afag Aghayeva, Ilknur Erguner, Bilgi Baca,
Ismail Hamzaoglu, and Tayfun Karahasanoglu. "Is da Vinci Xi better than da Vinci Si in robotic rectal cancer
surgery? Comparison of the 2 generations of da Vinci systems." Surgical laparoscopy, endoscopy & percutaneous
techniques 26, no. 5 (2016): 417-423

Common problems with exVive3D™ Kidney Tissue
Stringing: - Another potential and very regular issue is stringing, which is when spider web like
strands of plastic spread over the item you're printing. This happens when fiber spills out of the
spout and gets captured on the article. It is difficult to expel these "spider webs", and the item
frequently winds up being reproduced. However, before you squander valuable assets, have a go
at bringing down the warming temperature somewhat to limit hanging. Go gradually, changing
heat a smidgen at once, and see what occurs. In the event that that falls flat, take a gander at the
withdrawal settings on your printer. These qualities help pull additional plastic back far up into
the clouds from the item being printed and may take care of the issue.
Overheating of printer: Overheating frequently finishes in twisted and deformed articles, and it
typically happens when the working layers get littler, similar to when printing a pinnacle for
instance.
Layer neglects to connect. Everything was good to go to go, and afterward the 3D printer's yield
chose not to append appropriately to the surface being imprinting on. This is presumably the
most well-known issue looked by 3D printer clients8.
This initial layer is, obviously, what ties the remainder of the printing procedure, so once it
comes up short; practically none of the activity will print to particulars and will most likely twist.
That is the reason it's so essential to detect the issue and right it rapidly. There may be a few
8 King, Shelby M., J. William Higgins, Celina R. Nino, Timothy R. Smith, Elizabeth H. Paffenroth, Casey E.
Fairbairn, Abigail Docuyanan et al. "3D proximal tubule tissues recapitulate key aspects of renal physiology to
enable nephrotoxicity testing." Frontiers in physiology 8 (2017): 123

explanations behind the disappointment, yet the most probable is that the printer was not leveled.
This can mess beginning up with attachment yet in addition twist the printed object.
Other companies that repair or sell parts of the equipment include:
 L’Oréal: The company deals in sale of 3D printing materials used in the manufacture of
exVive3D™ Kidney Tissue with the sale price of a piece of the equipment being $12000
and takes 30 days for a delivery of an order
 Merck: The company deals in sale of 3D printing materials used in the manufacture of
exVive3D™ Kidney Tissue with the sale price of a piece of the equipment being $8500
and takes 21 days for a delivery of an order
References
Hagen, Monika E., Minoa K. Jung, Frederic Ris, Jassim Fakhro, Nicolas C. Buchs, Leo Buehler,
and Philippe Morel. "Early clinical experience with the da Vinci Xi Surgical System in general
surgery." Journal of robotic surgery 11, no. 3 (2017): 347-353
Kim, Da Hee, Hwan Kim, Sanghyun Kwak, Kwangha Baek, Gina Na, Ji Hoon Kim, and Se
Heon Kim. "The settings, pros and cons of the new surgical robot da Vinci Xi system for

transoral robotic surgery (TORS): a comparison with the popular da Vinci Si system." Surgical
laparoscopy, endoscopy & percutaneous techniques 26, no. 5 (2016): 391-396
King, Shelby M., J. William Higgins, Celina R. Nino, Timothy R. Smith, Elizabeth H.
Paffenroth, Casey E. Fairbairn, Abigail Docuyanan et al. "3D proximal tubule tissues
recapitulate key aspects of renal physiology to enable nephrotoxicity testing." Frontiers in
physiology 8 (2017): 123
Lamb, B. W., O. Alghazo, J. Goad, E. Upton, J. Hiller, N. Lawrentschuk, and D. Murphy. "The
da Vinci© Xi surgical system with integrated Table Motion can reduce the need for
Trendelenburg position without compromising surgical parameters." (2018)
Niclauss, Nadja, Philippe Morel, Minoa K. Jung, and Monika E. Hagen. "A comparison of the da
Vinci Xi vs. the da Vinci Si Surgical System for Roux-En-Y gastric bypass." Langenbeck's
archives of surgery 404, no. 5 (2019): 615-620
Ozben, Volkan, Turgut B. Cengiz, Deniz Atasoy, Onur Bayraktar, Afag Aghayeva, Ilknur
Erguner, Bilgi Baca, Ismail Hamzaoglu, and Tayfun Karahasanoglu. "Is da Vinci Xi better than
da Vinci Si in robotic rectal cancer surgery? Comparison of the 2 generations of da Vinci
systems." Surgical laparoscopy, endoscopy & percutaneous techniques 26, no. 5 (2016): 417-
423
Petro, Clayton C., and Yuri W. Novitsky. "Robotic Component Separation." In Laparoscopic
and Robotic Incisional Hernia Repair, pp. 129-140. Springer, Cham, 2018
Rifat, U. N., and M. Rifat. "3D Printing in Urology, The Current Position, And the Future:
Review Article." J Urol Ren Dis: JURD-164. DOI 10 (2017): 2575-7903