No, R2D2 isn’t holding the surgeon’s scalpel and Rosie the Robo-maid doesn’t don a nurse’s cap, but there is a robot in the operating room. Its name: the da Vinci.
Increasingly, surgeries are performed by doctors who never touch the patient. Costing approximately $1.5 million each, these robo-docs aid surgeons in procedures ranging from cardiac and urologic to gynecologic, physical therapy and general surgery. The technology has revolutionized the global medical community. And now, the robot is in El Paso.
The operating room at Providence Memorial Hospital looks like any other except for the large, four-armed da Vinci Surgical System standing at one end of a gurney. I’m here to meet the robo-doc in the flesh—or rather, in the steel. On first sight, it is slim, well-built, meticulously groomed, and surprisingly welcoming with outstretched arms. “Nice to meet you,” I almost say.
Dr. Michael Bagg, a urologist and the first El Pasoan to use the da Vinci on a patient, points out a dot-covered U.S. map on the wall above the robot’s operating system. “All those dots are where they’re using robotic technology. Now, we can draw one right over West Texas.”
Dr. Bagg explained that before the system’s arrival, many El Paso patients left town to have procedures done elsewhere by the da Vinci, but now they don’t have to.
Inside the Robot
The operation of the machine is similar to the common laparoscopy: The da Vinci is simply an up-upgrade. In traditional laparoscopy, the surgeon looks into a 2-D video screen, which provides a limited view of the surgical site. The scalpels, needles and other tools can be difficult to maneuver inside the patient, while human factors such as hand tremors, muscle fatigue, limited torque and so on, can lessen accuracy. The robot corrects these flaws, giving the surgeon a 3-D view, 540 degrees rotation and razor-sharp precision.
With the robot, the procedures stay the same, but the surgical approach is different. Doctors must be trained in either a fellowship or a da Vinci system formal course. “For me, it was all about the X-box,” jokes Dr. Bagg.
The viewfinder console at which the surgeon sits looks more like a video game than a high-tech medical device. At his feet are pedals to switch arms or move camera angles. At his fingertips are sensitive joysticks that control three of the four robotic arms wielding miniscule surgical instruments. Doll-sized and delicate, it’s easy to forget that these are used for cutting, cauterizing and suturing the human body. The robot’s absolute precision is only outdone by its might. “It’s strong. If you’re in the way of the arms, they knock you over,” said Juan Barraza, a surgical technician trained specifically on the da Vinci.
For complex operations, the robo-doc offers patients a less invasive procedure. The cuts are smaller and fewer. Four to five dime-sized incisions complete the surgery. This results in less post-operative pain, soft tissue trauma, bleeding and other complications, while offering a shorter recovery time.
“Normally, patients with hysterectomies are left with a huge scar across their abdomens,” explains Dr. Antonio de la Rosa, an
El Paso gynecologist using the da Vinci. “Now, not only is the scar small, but the overall pain of the procedure is vastly decreased.”
The da Vinci Past and Present Robotic systems have been in the operating room since the Puma 560 in 1985, a machine used for neurosurgical biopsies. The prototype for the da Vinci wasn’t introduced until the late 1980s. “It was originally designed by the U.S. Army for remote care of soldiers on the battlefield,” says Dr. Bagg.
The technology has since become widespread in civilian medicine. In 2000, the da Vinci became the first robotic surgical system approved by the Food and Drug Administration. Since then the technology has been instituted in numerous hospitals across the country and around the globe.
Not only that, da Vinci has brothers and sisters. Neuromate gives surgeons 3-D images of tumor locations during neurosurgeries. The twins, Orthodoc and Robodoc, work in tandem on prosthetic cases. Orthodoc designs hip prosthesis while Robodoc replaces them. InMotion2 and NeuroRobitic are personal physical therapists, helping patients perform repetitive exercises and recover mobility. Cyberknife shoots radiation beams to eliminate lesions in the body. Hmm… are we sure these aren’t characters in a sci-fi video game?
Telesurgery is the next step. “Telemedicine is an emerging technology for medicine,” said Irene Chavez, CEO of Providence Memorial Hospital. This would enable a surgeon in D.C. to operate on a patient in El Paso or a surgeon at Fort Bliss to work on a soldier in Iraq. The possibilities are endless.
Bottom Line
Don’t be afraid, this isn’t an I, Robot takeover. In the end, it comes down to patient care. Robots will never replace doctors, but they will help them improve patients’ lives. “I only see benefits to the technology. Patients who require surgery will still have the same physician contact and undergo the same experience, only with a better outcome,” said Dr. de la Rosa. These robots provide us, the human patients, with options.
If you want smaller scars, fewer cuts, less bleeding and faster recovery time, ask your doctor if your procedure can be done by the da Vinci. Stacy Dolan recently underwent a hysterectomy at Providence Memorial Hospital. Less than a week later, she said, “I haven’t had any pain or had to use pain medications. It’s good. I’ve been up walking around doing my normal activities. At first, I was terrified. I didn’t want a robot cutting on me. But my doctor explained it all and it’s been the best! I highly recommend it. If you can use the robot, I would.”
Surgeons hope that the promising results of the da Vinci in current operations will soon be duplicated in other areas of medicine. “We’re already using robotic technology in urology, gynecology and cardiac care, but pretty soon they’ll be using it in orthopedics, pediatrics, oncology and so on,” says Dr. Bagg.
The arrival of the da Vinci signals a modern era in the El Paso health system. Many believe it will become standard patient care. With the growth of the city and the anticipated population boom at Fort Bliss, the medical community must step up to meet demands. This is certainly an indicator of things to come.
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Editor's Note: This article was originally published in the January 2008 issue of El Paso Magazine.
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