Hospitals’ robotic surgical systems reduce pain and recovery time

02/24/2012 12:00 AM

02/24/2012 9:54 AM

It didn’t take much to convince 75-year-old Kenneth Brock that robotics surgery would be the best way to remove the throat cancer that was threatening to choke him.

“When they talked about it, I said this is the one for me,” said Brock, an on-call animal control officer for Halstead and Sedgwick. Just a few years ago, he’d marveled at what robotics could do when his grandchildren worked on their high school robotics projects.

Now, he’s even more impressed with robotics.

On Dec. 13, Philip Harris, an otolaryngology surgeon at Via Christi Clinic, removed the cancerous tumor that was rapidly filling Brock’s throat.

Brock was home within 48 hours of surgery and back to work within a few weeks. He’s undergoing speech therapy and depends on a feeding tube, he said, because his epiglottis, the flap that closes the trachea when eating, was removed.

Recovery from traditional throat cancer surgery is far more difficult. To reach the tumor and remove the cancerous tissue in a traditional surgery, the surgeon makes a large incision in the neck and often breaks the a patient’s jawbone for better access. Often the patient’s voice box has to be removed. Follow-up radiation therapy and reconstruction surgeries are usually part of the recovery process.

Brock avoided all that by having robotics surgery, considered by many health care professionals – and patients – to be the most effective, least invasive surgical option and one that has greatly improved patient care.

Within three hours of her robotics hysterectomy Dec. 19, Pam Bliss was up and walking. In a week and a half she was back at work as a staff member at Neurology Consultants. “I’m not saying I wasn’t in discomfort,” Bliss said. “It hurt a bit, but not the way I thought it would.”

The da Vinci Surgical System

The da Vinci Surgical System uses tiny robotic precision instruments and 3-D imaging that provides 10 times the magnification of the human eye. The surgeon manipulates the four robotic arms from a console about 3 to 4 feet from the patient.

The first da Vinci system in the Wichita area was installed at Via Christi in late 2007. In 2010, Via Christi added a second system. The demand by physicians and patients for robotics surgery has been so high that Via Christi added its third system in January. Ninety-eight percent of the prostatectomies and 79 percent of the hysterectomies performed at Via Christi are done robotically.

“We’ve pretty much been running full tilt,” said Brian Swallow, Via Christi’s director of surgical services. Via Christi’s two operational systems are used 12 hours a day, five days a week. More than 2,000 robotics surgeries – including colon resections, thyroidectomies, tonsillectomies, kidney surgeries and surgeries for head and neck cancer and relief of sleep apnea – have been performed at Via Christi.

Wesley Medical Center has two operational da Vinci systems, and the Kansas Medical Center in Andover started using its da Vinci Surgical System in October.

The Kansas Medical Center is the only area facility using da Vinci to repair the heart’s mitral valve, according to cardiac surgeon Badr Idbeis, the hospital’s CEO and chair of surgery. Patients who undergo such a surgery avoid a sternotomy, in which the breastbone is cut and spread open to give the surgeon access to the heart. Instead three much smaller incisions are made on the patient’s right chest.

Robotics simulator

Via Christi recently became the first Kansas medical facility to install a simulator to help surgeons hone the skills needed for the robotics system.

The simulator, located at Via Christi Hospital on Harry, helps “physicians train for the increasingly complex cases for which the da Vinci system is being used,” Swallow said.

Several surgeons have already jumped at the chance to use the system, on which surgeons complete various exercises, some even more complex than they do in actual surgeries. The surgeons get immediate feedback on skills such as range of motion.

Some surgeons use the simulator to “warm up” before going into the operating room to operate on patients, Swallow said.

‘Consumer-driven care’

Since performing Wichita’s first robotic hysterectomy in 2007, physician Jed Delmore, a University of Kansas School of Medicine-Wichita obstetrics and gynecology professor, has performed 400 hysterectomies, averaging about three a week. He also helps train medical residents on the skills they need to use the high-tech equipment.

He calls robotics surgery “the biggest example of consumer-driven care.”

“What’s unique about it is that it was driven by commercialism,” he said, “but the science of it turned out to be so advantageous for patients.”

The real advantages “are the camera that can see better than the human eye and the instruments that can be manipulated as well as or even better than my wrists,” said Via Christi Clinic physician Matthew Voth, who started using the robotics system about a year ago for gynecological surgeries.

He’s amazed at the system’s high-definition imaging that allows surgeons to see even more blood vessels and other parts of the anatomy that couldn’t be seen with traditional surgical magnification.

Patient care and recovery is usually much improved in surgeries done robotically compared with traditional surgery, according to health care experts. Robotic surgeries require smaller incisions, which means less blood loss, less scarring, lower risk of infections and faster recoveries. For example, a patient loses about one ounce of blood during a robotic hysterectomy, Delmore said.

The intricate tools and the high-definition camera mean surgeons can be more precise in what is cut or removed, preserving tissue and nerves surrounding the surgical areas.

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