New device offers help with surgery

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In the 1966 movie “Fantastic Voyage” doctors shrunk themselves and entered the human body to perform a surgical procedure.

Reality is coming closer to that vision with the da Vinci robot, recently brought on at Utah Valley Regional Medical Center to assist in a variety of cases. The robot is named after famed artist and inventor Leonardo da Vinci, who is believed to have created the first robot.

The Daily Herald was allowed inside a UVRMC operating room Wednesday to get an exclusive look at the robot. It involves a surgeon seated at a console, viewing a closeup of the area being treated. The robotic instrument has four arms, one of which is used to take a miniature camera to the area. And it’s not just any camera, but a high-definition 3D camera. The three other arms can have a variety of surgical instruments attached to perform the precise movements.

As the surgeon uses the master controls, the instruments respond in real time, with the benefit of being able to translate hand, wrist and finger movements.

“It is extremely helpful in deep, narrow spaces,” Dr. Steve Bigler of UVRMC said. “You can use it in a space that is too small for the human hand to work. Typically you will see it used in the two extremes of the abdominal cavity.”

It takes the idea of laparoscopic surgery to another level.

“Imagine doing surgery with chopsticks,” Bigler said. “They are straight. These are wristed instruments. You have 540 degrees of rotation. It is a very intuitive instrument.”

Bigler was observing Dr. Ric Rasmussen, assisted by Dr. Brian Gill, doing a hernia repair on an esophagus, the first surgery performed at UVRMC using the robot.

The surgeons had to take training classes to learn how to operate the controls for the surgical procedures.

“Initially they have to go through a pretty rigorous training course,” Bigler said. “They are proctored by an experienced robotic surgeon for the first few cases.”

“They had to be passed off with a proctor,” said Brenda Bean, a gynecological, urological nurse specialist and the robot coordinator at UVRMC. “Dr. Gill is a proctor.”

Bigler said there are a variety of teaching methods used to get the physicians up to speed with what the robot can do.

“The robot manufacturer has training modules,” he said. “Our surgeons also have to go through and spend time training every year.”

The hospital personnel will also do evaluations.

“We will be reviewing, through the robotic committee, all robotic cases and outcomes,” Bigler added.

At present, most of those cases are gynecological and urological, plus a selection of general surgery cases.

“In the future there may be some ear, nose and throat application for the robot,” Bigler said. “A few places in the country use the robot for some cardiac procedures. Intermountain has not done that yet.”

There are some possibilities for the surgery that could go beyond traditional hospital boundaries.

“In the military you could have a robot up in a battlefield and the surgeon in the U.S. sending instructions by satellite,” said Bigler, stressing that under ideal circumstances, however, the surgeon is always in the room with the patient, to be available in case of any emergency.

Bigler praised the technology.

“The actual surgery tends to go more smoothly,” he said. “That is because you can use the articulating arms in a small space.”

“This helps the surgeons have more mobility with their hands,” Bean added. “They can do more with a robot than a straight laparoscopic procedure.”

Both robotic surgery and laparoscopic procedures are considered minimally invasive, compared to traditional surgery in which a larger incision is made. The minimally invasive style has a lesser impact on the patient.

“The patients can go home much quicker,” Bean said. “Instead of having to stay in the hospital a week, they can go home the next day.”

More information, including videos of the da Vinci robot being used to peel a grape and paint a picture, is available at www.davincisurgery.com.

 

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