da Vinci Robot Surgery: Is There a Robot in Your Future?

By: Allen Weiss, MD, MBA, FACP, FACR

da Vinci Surgical Robot now at NCH
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December 15, 2005 - In September, 2005 a surgeon in the NCH Healthcare System performed the first robot- assisted surgery on the west coast of Florida using the da Vinci Robot. Robot surgery is an exciting new technology that makes recovery for patients easier, safer, and faster. In the near future prostate removals, hysterectomies, and some heart valve repairs will be done with minimal incisions using the robot. What is robot surgery and why does this technology lead the way for future trends in surgery?

First, what is the da Vinci Robot? Let’s start with some background for the non-surgeons among us. During the 1980s, surgeons first started to commonly do surgery inside the abdomen by inserting a tube that contained surgical instruments, lights, and a camera through a few small incisions on the wall of the abdomen. This tube was called a laparoscope and this technique was called laparoscopic surgery. The laparoscope was used primarily to remove gall bladders and do certain gynecological procedures. The patients were left with only a few small “band-aid” size incisions and were usually out of the hospital within 24 hours. The standard gall bladder operation performed before laparoscopic surgery was available left a patient with a scar of a few inches long and required a week’s hospital stay.

Laparoscopic surgery was a great improvement on conventional surgery but was limited by having to use instruments inserted through the long tube or laparoscope. Simultaneously, computer scientists were developing remote computer-controlled instruments that mimic the motions of a hand. This early laparoscope evolved into the replication of the surgeon's hand within the tube, which is actually the robot. This new robotic technology was primarily geared to the armed forces and others who needed to perform complicated tasks in hostile or dangerous places. Using computer technology, the movements of a surgeon’s hand could be replicated remotely at the end of a laparoscope, controlling a set of instruments that have been inserted through the abdominal wall into the belly to perform surgery. Although this may sound like science fiction, the computer-assisted movements can control for tremor and/or extraneous motions. Small cameras with lights allow the surgeon to view the surgical areas three dimensionally and with magnification. This is actually a better view than the surgeon would have with conventional surgery.

Named after Leonardo da Vinci whose sketches reveal the invention of the first robot in the closing years of the 15th century, the present-day da Vinci Robot's major advantage is to the patient. Instead of having a large incision that causes pain and slows recovery, the patient undergoing robot surgery leaves the operating room with a few small band aids on the belly. This is much less painful—the patient is up and usually out the next day. The major problem with conventional surgery is getting to the site of the operation. The actual removal of the prostate or uterus is not nearly as hard as physically getting the surgeon’s hand to the prostate or uterus. Robot surgery gets right to the site of surgery without creating more problems which slow subsequent recovery.

Thus far the NCH Healthcare System has been host to over fifteen different robotic procedures that have all been successful with da Vinci Robot surgery performed by surgeons on staff. The prostate has been the prime area for surgery but we are hopeful to have some of the gynecologists trained in the future to use this technique for pelvic surgery. Similarly, our cardiac surgeons are exploring the use of the da Vinci for heart valve repair. Surgery performed this way would require a smaller incision thought the skin on the chest wall and allow a faster recovery.

The technology used today by progressive health care systems saves patients and families a tremendous amount of pain. These techniques were originally developed so that surgery could be done remotely on the battlefield without risking the lives of medical personnel. Sharing this technology with society helps everyone. The NCH Healthcare System is proud to be able to be the first to offer the da Vinci Robot to all of the patients in southwest Florida.

For more information on the da Vinci Robot at NCH, please contact the Access Healthline at (239) 436-5430.

Dr. Allen Weiss is President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.