Robotics give boost to delicate surgery
Area Sales Director for Intuitive Surgical Steve Thompson watches the monitor as Kathy Rea, a nurse at North Valley Hospital, tries out the da Vinci Surgical System Tuesday afternoon.
Intuitive to the surgeon's hand movements, the technology allows for complex surgeries to be done with smaller incisions.
North Valley Hospital has acquired a new robotic system that offers less pain and a lot of gain for patients needing urological or gynecological surgery.
Dr. Mirna Bowden, chief of staff at the Whitefish hospital, said the da Vinci S system allows surgeons to operate through smaller incisions with greater dexterity and range of motion as well as a magnified three-dimensional view.
“Patients reap the rewards,” Bowden said.
With benefits including less pain, reduced recovery time and minimal scarring, it’s not surprising that robotic surgery has fired interest across America via the Internet.
Bowden, a gynecologic surgeon, and Dr. Jonathan Mercer, a urological surgeon, agree that patients have driven the expanded use of this kind of surgery.
“People are very savvy,” Bowden said. “They get on the Internet and they learn about robotics.”
Mercer said that surgeons now use robotic equipment in 75 to 80 percent of surgeries to remove the prostate gland, up from 15 to 20 percent just two years ago. He said it’s unclear if this approach produces better surgical outcomes but patients definitely benefit in other ways.
“The data has shown shorter hospital stays and a quicker return to normal activity,” Mercer said.
Bowden said the same applies to gynecological procedures. She called this system a new tool allowing surgeons to perform the same major surgeries but through tiny incisions.
Before North Valley Hospital invested in the da Vinci system, patients had to travel out of the area if they needed a complex procedure but wanted to avoid the longer recovery of open (large incision) surgery.
Bowden used the example of complicated hysterectomies that require a large incision and a two- or three-day hospital stay.
“With the robot, a surgery now can be done through tiny incisions as an outpatient procedure,” she said.
On Jan. 11, the da Vinci S HD equipment from Intuitive Surgical arrived at North Valley Hospital. It includes a free-standing, four-armed “robot” that stands next to the patient and a console where the surgeon operates through the system.
During a very precise set-up procedure, the surgeon and operating team place the robot cart, then insert the cameras and micro-instruments into the patient through small incisions. Moving to the console a few feet away, the surgeon moves fingertip controls while watching a screen with a 3-D, high-definition view of the operating area.
Unlike traditional robots that operate alone after programming, this equipment leaves the surgeon in control but with increased precision.
“From a surgical perspective, it feels like you’re right there but very close up,” Bowden said.
The 3-D HD aspect gives surgeons more than twice the resolution and 20 percent more viewing area compared to other minimally invasive systems, allowing surgeons to perform delicate tissue dissections and reconstruction procedures.
Bowden said the controls also provide tactile feedback, comparing it to the experience of playing Wii games.
“You feel yourself feeling tissue,” she said.
This technology maintains eye/hand/instrument alignment, reducing the training curve. If the surgeon twists the controls clockwise, the instruments twist clockwise, unlike laparoscopic instruments.
“Laparoscopic was much harder to learn,” Bowden said. “This is very intuitive.”
North Valley Hospital has scheduled the first robotic procedure for early February. As other surgeons complete training on the system, the hospital expects to expand its use to general and ear, nose and throat surgeries.
“We’re just on the tip of the iceberg on the number of applications,” Mercer said.
Since 2000, the da Vinci equipment has been used for thousands of procedures. The Whitefish location is one of 800 sites across the country and 1,100 around the world.
According to the manufacturer, North Valley Hospital is the first limited access hospital to purchase the system. Cost presents a barrier to many rural health care facilities.
Although the system required a hefty investment, hospital Chief Executive Officer Jason Spring said North Valley expects to attract and retain patients as well as help recruit professionals.
“We think it’s something the community deserves and demands,” he said. “We asked ourselves, ‘How can we afford not to do it?’”
Spring, Mercer and Bowden say that this equipment represents the future of surgery. They said it will become standard in all hospitals in the next few decades.
Bowden described operating with the da Vinci system as the difference between driving a Ferrari and a Volkswagen.
“Rural medicine should no longer mean second-class medicine,” she said.
Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.