# 500th Anniversary of Leonardo Da Vinci’s Death

Today, to mark the 500th anniversary of his death, we pay tribute to one of the greatest minds humankind has ever had: Leonardo Da Vinci.

#### Leonardo Da Vinci: Artist or Scientist? (Sona Popat)

Leonardo Da Vinci (Figure 1), who was born on April 15th, 1452 and died on May 2nd, 1519, was an Italian polymath, renowned now for his skills in many fields, particularly the arts. In fact, he trained as an artist from a young age: at 14, Da Vinci apprenticed under Andrea del Verrocchio, developing skills in drawing, painting and sculpting, as well as mechanics, carpentry, architecture and chemistry.[1] Da Vinci soon began taking commissions on his artwork, and went on to set up his own studio after moving to Milan in around 1481.

Now, on the 500th anniversary of his death, Leonardo Da Vinci is still recognized across the world as one of the greatest artists of all time, with museums and galleries celebrating the anniversary of his death by showcasing his contributions towards art and society and local sellers selling replicas.[2] However, although he is most famous for artwork such as the Mona Lisa and The Last Supper, Da Vinci was undoubtedly also a scientist.

“All our knowledge has its origins in our perceptions

– Leonardo Da Vinci [1]

In this quote, Da Vinci describes the exploration of the natural world using observation, a scientific method he used to improve his understanding in both anatomy and machinery, which he then instilled in his art.[3] His repetitions in dissecting and depicting the human body, and comparing his findings to those he had observed in the mechanical world are very similar to scientific methods used in investigations today. Da Vinci’s understanding of science through art allowed him to see parallels between the natural and mechanical worlds. For example, he modelled paintings of skin after the peel of an onion[4], studied birds to design human flight machines[1], and observed the similarities between the human embryo and the maturing seeds of plants.[3]

Though few came to fruition during his lifetime, Da Vinci’s many inventions, such as the first conceptual ideas of a parachute, plane, and robot[5], have oftentimes influenced the progress of modern technology. He is celebrated today as the father of concepts which have led to revolutionary technologies such as the Da Vinci surgical system, which now allows surgery to be minimally invasive through the use of robotic aid.

Thus, Da Vinci is both a scientist and an artist, and his contributions to both of these fields have shown that they work hand in hand. Renowned American writer and journalist Walter Isaacson[6] wrote that “the ability to make connections across disciplines — arts and sciences, humanities and technology — is a key to innovation, imagination, and genius”. Da Vinci is a prime example that free thinking and an interdisciplinary approach to innovation are still just as crucial to scientific discovery today.

#### Exploring a Da Vinci Invention: The Parachute (Omodolapo Bolinda)

Leonardo Da Vinci is credited for the idea behind several critical inventions: one such invention is the parachute. Although credit for the first prototype of a parachute is given to French inventor Sebastien Lenormand in 1783, almost 300 years previously, Leonardo Da Vinci drew up designs for the parachute (Figure 2).[7]

He declared ​“If a man has a tent made of linen of which the apertures[openings] have all been stopped up, and be it twelve bracchia [openings] across [over twenty-five feet] and twelve in depth, he will be able to throw himself down from any height without sustaining injury”.[8]​

Some 500 years after he sketched the design for the world’s first known parachute​, Leonardo Da Vinci’s design was proven practicable. ​ In 2000, A British man by the name of Adrian Nicholas dropped from a hot air balloon 3,000 meters (10,000 feet) above the ground using Da Vinci’s design. Nicholas even went as far as to only use materials that would be available in medieval Milan, resulting in a final product weighing around 200 pounds. Yet, after completing his journey, Mr. Nicholas commented the ride was smoother than modern day parachutes.[9]​

#### Leonardo Da Vinci’s Contribution to Human Anatomy(Sophie Obomighie)

Da Vinci’s quest to understand the human body led him to carry out research in the fields of anatomy and physiology.[10,][11] Da Vinci’s carefully crafted drawing of structures of the human body (Figure 3), and especially the body’s vascular system, reflects his artistic skill and scientific nature working hand in hand. Many of his sketches at the start of his artistic career were inaccurate representations of the human anatomy, mostly because at this time these drawings were based on unconfirmed hypothesis and not actual anatomisation. To improve his skill as an artist – and perhaps to satisfy his scientific curiosity – Da Vinci began carrying out dissections presumably upon moving to Milan[11] and acquired his first skull in 1489.

Most of his work was focused on the skeleton and muscles, of which he made numerous incredibly meticulous sketches. In fact, Da Vinci had hardly any drawings of internal organs like the kidney and liver, presumably because of their delicate nature in preserving and cutting. However, he probed the heart, brain and lungs and concluded that they are the ‘motors’ of the senses and of life.[11]
Starting from the ancient proportional theory proposed for the first time by the Roman Vitruvius, he demonstrated that the ideal proportion of the human figure is equivalent to the structure of the circle and square. He thus came up with the Vitruvian man (Figure 4) and showed that a person can be contained within 4 lines of a square when he outstretched his arms with his feet firmly on the ground. When the upper and lower limbs are outstretched like that of an eagle, he can be inscribed in a circle.

He continued these anatomical studies throughout his time in Milan, Florence and Rome and by 1511, he had dissected 30 cadavers.[11] These studies were deeply influenced and supported by Professor Marcantonio della Torre, who Leonardo had met in Pavia.[11] Their relationship kept on going on until, unfortunately, Marcantonio died in 1511 which led Da Vinci to drop his anatomical projects altogether. Yet, before ending such projects,  Da Vinci was able to make several crucial discoveries. During Da Vinci’s study, he discovered that the humors did not reside in the three cerebral ventricles (anatomical structures defined with molten wax) and that the heart was the core of the blood system. Not only that, he was the first to describe atherosclerosis and hepatic cirrhosis as well as the coronary sinuses about 200 years before Valsalva named them.
Leonardo Da Vinci did not consider himself an expert in anatomical studies; by consequence he did not teach nor publish his findings, with the exception of human proportion. Da Vinci did not publish his work before his death, most likely due to the disapproval of human dissection by law at that time. Some time after his death, the Flemish Physician Vesalius did publish Da Vinci’s findings within the book De humani corporis fabrica in 1543, which made a significant contribution to Renaissance science.[10]

#### The Da Vinci Surgical System: the Era of Robotic Medicine(Roberto Parisi)

Conventional surgery often can leave several scars on patients’ skin, sometimes causing the loss of large quantities of blood.[12] Laparoscopic surgical techniques are performed with the insertion of a viewing tube (called laparoscope) into the surgical area and were started in 1987[13] by Philippe Mouret with cholecystectomy (surgical removal of the gallbladder).  They represent a valid medical alternative and are characterised by a variety of clinical advantages. Specifically, because the number and size of the surgical incisions are smaller, it is less likely for the patient to develop infections or have dehiscence, the involuntary re-opening of surgically-sutured wounds.
In the 1990s different military projects involving organisations such as NASA developed the first examples of telerobotic systems. Designed to safely explore dangerous sites[14], soon robots found application in the surgical area, allowing doctors to operate soldiers without physically being in the combat zone.[15] The Computer Motion, an American medical company, created Aesop in the same period. This device was approved by the U.S. Food and Drug Administration (FDA) in 1994 and it consists of an endoscopic camera inserted in the body during laparoscopic surgeries.[14][16]
In 2000, the FDA approved the Da Vinci surgical system. The name of the device derives from the visionary Leonardo Da Vinci, who, during the Renaissance period, managed to describe the archetype of the modern robot.[17] In fact, some of Da Vinci’s notebooks, dating all the way back to 1495, contain sketches of a robotic knight (Figure 5), probably an extension of his anatomic studies begun with the analysis of proportions described with the Vitruvian man.[18] This robot was designed to be operated with a complex system made of ropes, pulleys and gears.

The Da Vinci surgical system (Figure 6), while in some ways much more complex than even Leonardo Da Vinci could have dreamed of, still retains some of the fundamental features of robots that he imagined. This device consists of a surgeon’s console, two robotic arms equipped with microsurgical instruments and a third arm equipped with an endoscopic camera.[14] The surgeon sits at the console in an ergonomic posture and controls the movement of the surgical arms via telemanipulation.[19] The images regarding the surgery are transferred from the two-channel endoscopic camera to the surgeon’s console, where the doctor is able to get a 3D view, as if they were looking directly in the patient’s body. Some of the most common surgeries completed via robotic surgery are cholecystectomies and splenectomies.[20][21] In more than the 90% of all the conducted operations, the results are positive, but in some cases, due to clinical complications, it is necessary to convert to open surgery.[19]
The advantages of the Da Vinci surgical system include faster healing for patients and, consequently, a significant reduction of the hospitalisation periods for medical structures. There is evidence that after laparoscopic surgery, the hospitalisation period is reduced by about two days of common recovery and that open surgery costs about $9000 more than laparoscopy.[22]. Different studies show that despite having lower complications and shorter length of stay, the hospitalisation costs after robotic-assisted surgery are higher than the ordinary procedures of open surgery (for a prostatectomy, about$12,000 vs. \$9,400).[23] Since robotic surgery is a minimally invasive technique, the risk of developing wound infections is, in fact, nearly nonexistent.[24] However, surgical robots can be disadvantageous if the long learning periods needed of medical staff to correctly conduct operations are taken into account. What is more, these kinds of devices cost about 1.5 million dollars[25] and lack tactile feedback.[24] This last obstacle can be overcome by the implementation of a haptic interface[26], technology that could allow surgeons to feel the tissues and the organs as if they were operating in open surgery.
While it is still early to understand how surgery will evolve in the future, the technical advantages shown by these robotic devices suggest that they will continue to play an important role in surgical technology over the coming years.

#### Conclusion

It would be amazing to see Leonardo Da Vinci’s reaction to all the technological advancements made since his death, half a millennium ago. Surely Da Vinci would recognise several of his projects, such as the parachute or the robots investigated in this article, and be happy to know that his mind has inspired many researchers to create devices that can improve health and lifestyle in general. To honour the 500th anniversary of Da Vinci’s death, we are very pleased to write about such a brilliant mind that, despite the centuries between us, has been able to think outside the box and to design inventions that we have only acquired in the last few decades.

### References

1. Debbie Sniderman, “Leonardo Da Vinci”, ASME, April 2012, https://www.asme.org/engineering-topics/articles/history-of-mechanical-engineering/leonardo-da-vinci.
2. Nora Walsh, “Celebrating the 500th Anniversary of Leonardo”, New York Times, February 12, 2019, https://www.nytimes.com/2019/02/12/travel/leonardo-da-vinci-travel-tours-museums.html.
3. “Leonardo da Vinci Biography”, Leonardo da Vinci, accessed April 26, 2019, https://www.leonardodavinci.net/leonardo-da-vinci-biography.jsp.
4. “Comparison of Scalp Skin and Onion”, Leonardo Da Vinci, accessed April 26, 2019, http://www.leonardo-da-vinci.net/comparison-of-scalp-skin-and-onion/.
5. Elizabeth Palermo, “Flying Machines? 5 Da Vinci Designs That Were Ahead of Their Time”, Live Science, December 19, 2014, https://www.livescience.com/49210-leonardo-da-vinci-futuristic-inventions.html.
6. Walter Isaacson, Leonardo Da Vinci (Simon & Schuster, 2017).
8. Anthony K. Brandt and David Eagleman, The Runaway Species: How Human Creativity Remakes the World (Edinburgh: Canongate Books Ltd, 2017).
9. Ashley Loveland, Carlos Cruz, Melissa Carrillo and Sean D Allen, “The Life and Works of Leonardo di ser Piero da Vinci”, Studylib, accessed March 24, 2019, https://studylib.net/doc/7123972/leonardo-da-vinci-final​.
10. Roger Jones, “Leonardo Da Vinci: Anatomist”, British Journal Of General Practice 62, no. 599 (June 2012): 319-319, https://doi.org/10.3399/bjgp12X649241.
11. Ludwig Heinrich, “Leonardo Da Vinci – Anatomical Studies And Drawings”, Encyclopædia Britannica, last modified April 28, 2019, https://www.britannica.com/biography/Leonardo-da-Vinci/Anatomical-studies-and-drawings.
12. Riaz Ahmed Agha and Gordon W. Muir, “Does Laparoscopic Surgery Spell The End Of The Open Surgeon?”, Journal of the Royal Society of Medicine 96, no. 11 (December 2003): 544-546, https://doi.org/10.1258/jrsm.96.11.544.
13. “Storia | Docteur Philippe Mouret”, Docteur Philippe Mouret, accessed April 26, 2019, http://www.philippemouret.com/index.php/about/?lang=it.
14. Sanjay Saraf, “Robotic Assisted Microsurgery (RAMS): Application In Plastic Surgery”, IntechOpen, January 1, 2008, https://doi.org/10.5772/5261.
15. M. Cubano, B. K. Poulose, M. A. Talamini, R. Stewart, L. E. Antosek, R. Lentz, R. Nibe, M. F. Kutka and M. Mendoza-Sagaon, “Long Distance Telementoring”, Surgical Endoscopy 13, no. 7 (July 1999): 673-678, https://doi.org/10.1007/s004649901071.
16. François Pugin, Pascal Bucher, and P. Morel, “Histoire De La Chirurgie Robotique : D’AESOP À Da Vinci® En Passant Par Zeus®”, Journal De Chirurgie Viscérale 148, no. 5 (October 2011): S3-S8. https://doi.org/10.1016/j.jchirv.2011.03.009.
17. Anthea Gerrie, “The da Vinci code: why a robotic system replaces ‘chopstick’ surgery”, Medtechengine.com, October 14, 2016, https://medtechengine.com/article/da-vinci-surgical-system/.
18. David R. Yates, Christophe Vaessen and Morgan Roupret, “From Leonardo to da Vinci: the history of robot‐assisted surgery in urology”, BJU International 108, no. 11 (December 2011): 1708-1713, https://doi.org/10.1111/j.1464-410X.2011.10576.x.
19. Johannes C.Bodner, F. Augustin, Heinze Wykypiel, John W. Fish, Gilbert Muehlmann, Gerold J. Wetscher and Thomas M. Schmid, “The Da Vinci Robotic System For General Surgical Applications: A Critical Interim Appraisal”, Swiss Medical Weekly 135, no. 45-46 (November 19, 2005): 674–678, https://doi.org/10.4414/smw.2005.11022.
20. “Robotic Advance Helps Cholecystectomy Surgeons”. 2012. Springer Healthcare News 1 (1). doi:10.1007/s40014-012-0051-1.
21. Davide Cavaliere, Leonardo Solaini, Daniela Di Pietrantonio, Fabrizio D’Acapito, Francesca Tauceri, Massimo Framarini and Giorgio Ercolani. “Robotic vs Laparoscopic Splenectomy For Splenomegaly: A Retrospective Comparative Cohort Study”, International Journal Of Surgery 55, (July 2018): 1-4, https://doi.org/10.1016/j.ijsu.2018.05.012.
22. “Laparoscopic Anti-reflux Operations for GERD is Linked to Fewer Postoperative Complications and a Faster Recovery Compared with an Open Procedure”, American College of Surgeons, January 26, 2017, https://www.facs.org/media/press-releases/2017/gerd012617.
23. Simon P. Kim, Nilay D. Shah, R. Jeffrey Karnes, Christopher J. Weight, Nathan D. Shippee, Leona C. Han, Stephen A. Boorjian et al., “Hospitalization Costs For Radical Prostatectomy Attributable To Robotic Surgery”, European Urology 64, no. 1 (July 2013): 11-16, https://doi.org/10.1016/j.eururo.2012.08.012.
24. Tanya Todd, “Da Vinci Robotic Surgery: Pros And Cons”, SteadyHealth, March 30, 2010, https://www.steadyhealth.com/articles/da-vinci-robotic-surgery-pros-and-cons.
25. Adam Pick,”How Much Does The Da Vinci Surgical Robot Cost?”, Adam’s Blog, HeartValveSurgery.com, September 16, 2008, https://www.heart-valve-surgery.com/heart-surgery-blog/2008/09/16/how-much-does-the-da-vinci-surgical-robot-cost/.
26. Allison M. Okamura, “Haptic Feedback In Robot-Assisted Minimally Invasive Surgery”, Current Opinion In Urology 19, no 1. (January 1, 2009): 102-107, https://doi.org/10.1097/mou.0b013e32831a478c.

#### Figure References

1. By Wikicommons, Leonardo’s self portrait, 1512.
2. Nevit Dilmen [CC BY-SA 3.0] “Leonardo da Vinci Parachute”, https://commons.wikimedia.org/wiki/File:Leonardo_da_Vinci_parachute_04659a.jpg
3. Particular from “Two views of the skull”, Leonardo Da Vinci, Royal Collection of Windsor
4. By WikiImages, Pixabay, https://pixabay.com/it/photos/umano-leonardo-da-vinci-62966
5. By Wikicommons, Erik Möller. Leonardo Da Vinci. Mensch – Erfinder – Genie exhibit, Berlin 2005. – Own work.
6. Robot Da Vinci – surgery. Visage Technologies. Face Tracking and analysis.