The surgeon console is the control center for the robotic platform. From the surgeon console, the surgeon can control the endoscope and instruments by using the hand controls and footswitch panel . All actions taken by the surgeon at the console are relayed to the vision system for processing and sent to the patient cart for implementation. The surgeon console is made up of several components that are similar on the two latest versions of the robotic system (Si/Xi): stereoviewer , master controllers , touchpad , and the footswitch panel (Fig. 16.2). One of the added benefits of the surgeon console is that it can be paired with a second console to allow two surgeons to work simultaneously on the same patient (Fig. 16.3). This feature can be used to collaborate with other surgeons, for proctoring, and for teaching.

The stereoviewer provides a high definition 3D view of the surgical field that can be magnified up to 10× (Fig. 16.2). The stereoviewer is ergonomically designed to support the surgeons head and neck during surgical procedures. Additionally, the stereoviewer displays messages and icons to the user about the system status.

The master controllers use fingertip controls that allow the surgeon to control the endowristed instruments and endoscope (Fig. 16.4). They are also designed with ergonomics in mind to optimize the comfort of the surgeon. The surgeon’s movements are instantaneously replicated at the patient cart while also filtering out potential hand tremors. With the addition of motion scaling the surgeon can fine tune the hand-to-instrument movement ratios to their choosing.

The user interface controls are housed in pods on the left and right side of the surgeon console arm rest (Fig. 16.2). The left sided pod contains the ergonomic control levers that allow the surgeon to adjust the height and tilt of the stereoviewer , adjust the armrest up or down, and move the footswitch panel in or out. The user’s unique settings can be saved and when the user logs into the system they are automatically recalled. The right sided pod contains the power button and emergency stop button.

A touch pad is located in the center of the surgeon console armrest (Fig. 16.2). The touchpad can be used by the surgeon to save and access their own user preferences and ergonomic settings. Again, when the surgeon logs into the system their system preferences and ergonomic settings will automatically be recalled. After logging in, a home screen will appear that gives the surgeon access to surgeon console controls and settings. Along the bottom of the screen, there are tabs for accessing video, audio, and utility preferences. The video tab gives the surgeon the ability to adjust brightness, make advanced video adjustments, modify camera and endoscope setup, and access display preferences. The audio tab allows for volume adjustments and/or muting the surgeon console microphone. The utility tab allows entry into account management, inventory management, event logs, and control preferences; scaling, finger clutch, TilePro QuickClick, haptic zoom, master associations. There are also three quick settings buttons down the middle of the touchpad that contain settings for scope angle, zoom level in the stereoviewer , and motion scaling.

Lastly, the footswitch panel is used by the surgeon for robotic arm swapping, master clutching, cameral control, and instrument activation and control (Fig. 16.5). The left lateral pedal allows the user to swap control of the instrument arms so the user can control a different instrument arm with one of their master controllers . This is done by tapping the pedal with the side of your foot. The left upper pedal is a master clutch pedal and can be used to decouple the masters from the controls of the instruments which allows the user to relocate the masters for improved comfort. The left lower pedal is the camera clutch and allows the user to control the focus and position of the endoscope . The right sided foot pedals are used for instrument activation and control. For example, the right sided foot pedals can be used by the surgeon to activate the coagulation function of a vessel sealer as well as the cutting function when necessary.

The patient cart is composed of several components. The setup joints position the robotic arms to optimize range of motion for the endowristed instruments and endoscope (Figs. 16.6 and 16.7). The instrument arms and the camera arm(s) on the Si and Xi systems interface with the robotic instruments and the camera assembly . The instrument and camera arms are draped for sterility and allow the surgeons and/or assistant to attach and adjust the robotic instruments and camera assembly at bedside. The instrument and camera arms also give the surgeon control over the robotic instruments and endoscope . The robotic arms use remote center technology, allowing the instruments and camera assembly to move around a fixed point in space. LEDs on top of the robotic arms provide feedback on the arm status to the surgeon/assistant.

The greatest difference between the Si and Xi systems lies with the patient cart (Figs. 16.6 and 16.7). One of the enhancements to the patient cart is the adjustable column and overhead boom. The boom is an adjustable support structure from which the robotic arms are now attached. The boom allows easier docking, extended range of motion, as well as more flexibility with patient positioning. The docking process has also been enhanced with the use of a laser pointing system that helps direct arm placement. The arms on the Xi system are also smaller, lighter, and now universal, meaning the instruments and endoscopes can be used interchangeably in any of the robotic arms. Additional upgrades to the endoscope have also been made. The endoscope no longer needs calibration, white balance, or draping.