Robotic surgery: Southeast Hospital in on the beginning of a revolution

Sunday, February 19, 2006

According to Newsweek magazine, an estimated 36,600 robotic procedures -- including heart-bypass surgeries, kidney transplants and hysterectomies -- were performed in 2005. The number is predicted nearly to double in 2006.

Robots were first introduced to medicine in 1987. By 2000, the $1.3 million da Vinci surgical system was approved by the U.S. Food and Drug Administration for use in laparoscopic surgical procedures. In 2001, the FDA cleared da Vinci for use during laparoscopic removal of the prostate.

Already the robotic system has transformed the field of prostate surgery in the number of surgeries performed, better patient results, quickened healing time and a 14 percent higher rate of cancer removal in one study.

The da Vinci surgical system, currently in use at Southeast Missouri Hospital for prostate removal only, is expected to be used in future applications as well. Southeast Missouri Hospital is the third hospital in Missouri and the first community hospital in the state to offer robotic assisted surgery. Physician specialists from Cape Girardeau Urology Associates who use the system can surgically remove the prostate gland, resulting in procedures that deliver greater precision, require smaller incisions and reduce blood loss.

Robots enhance a surgeon's performance by compensating for hand tremors and offering a 3-D image with 10 times the field magnification. Thin, robotic arms promote smaller incisions, fewer complications and a faster return to normal daily activities.

A traditional radical prostatectomy would require an 8- to 10-inch incision and at least two days' hospitalization.

Opting for the surgery using the da Vinci robotic system, one patient described the discomfort from the largest incision (about 2 inches long) to that of a bad pimple. Walking within hours of his surgery, the patient was discharged the next day. After 10 days he was back to work. Two months later he'd regained normal urinary and most sexual function.

The first major study to compare open and robotic prostatectomies, published in 2003 in the British Journal of Urology, surveyed 300 patients and found those that had open surgery lost five times as much blood, had four times the risk of complications and remained in the hospital more than three times as long as those who had robotic surgery. Half of the open surgery patients did not regain full sexual function two years later, while robotic surgery patients were able to have sexual intercourse in about 11 months.

Some surgeons have found it difficult to use the instruments while watching a video monitor. The commitment to learn robotic techniques can help surgeons learn a new set of skills.

cpagano@semissourian.com

335-6611, extension 133

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