A generation ago we debated whether robots would ever play a role in medicine. Today, doctors and robots have—literally—joined hands to perform complex surgical procedures.

 

 

The unique partnership between doctors and robotic technology at Ingham Regional Medical Center has yielded impressive results. Small poke-hole cuts take the place of inches-long incisions. Patients typically have fewer side effects, and less blood loss, pain and scarring. Overall recovery takes weeks instead of months.

Technically speaking, robotic surgery is minimally invasive laparoscopic surgery performed with the assistance of robotic technology. The robot cannot be programmed or make decisions on its own. The technique melds highly skilled surgeons with robotic precision, vision and dexterity otherwise not humanly attainable.

Instead of holding instruments, a robotic surgeon sits at the console of the da Vinci Surgical System. The robot’s camera and surgical instruments are placed into ports inserted through a few small punctures. A binocular-eyepiece lens provides a 3-D true-to-life view inside the patient with up to 15 times magnification.

The surgeon controls pencil-sized instruments on the da Vinci’s robotic arms—each with a tiny wrist-like joint. The joint gives flexibility that rivals the human hand and surpasses traditional laparoscopic devices. A specialized computer program translates movements at the controls into precise micro-movements.

The applications are exciting; however, in particular the da Vinci has revolutionized surgery for prostate and gynecological cancers. These complex pelvic-area procedures require a great deal of precision in a densely packed space.

Robotic-assisted prostatectomy 

Prostate cancer is the No. 2 cause of cancer death for men. Each year after age 40, risk for the disease increases. One out of every six men will ultimately be diagnosed.

If it is caught in an early, localized stage, surgical removal of the prostate delivers cure rates exceeding 90 percent. However, potential side effects of incontinence and impotence are daunting.

The prostate is positioned deep in the abdominal cavity—between the narrow pelvic bones, just below the bladder. It partially surrounds the urethra and is wrapped with delicate nerves that control potency. Deft and precision are required to remove the prostate without damaging delicate nerves or muscles.

On this difficult surgical terrain da Vinci’s capabilities shine. A robotic prostatectomy is conducted via six pen-size holes, instead of an eight-inch incision. Fine articulating instruments and magnified vision make it easier to remove cancerous tissue, separate delicate nerves from the prostate, and finely suture the urethra back to the bladder, while sparing the pelvic floor muscles and urinary sphincter.

The results are remarkable. Blood loss is usually greatly reduced. Hospital stays can be cut by half—24 hours versus two or three days—and so can post-operative catheterization. Patients often return to normal activities within two weeks, compared to a few months with traditional surgery. Studies indicate urinary and sexual function return more quickly and in a greater number of cases.

Robotic-assisted hysterectomy 

The benefits of robotic surgery don’t discriminate. They also apply to hysterectomy—the second most common female surgery and a treatment for a range of gynecologic problems including fibroid tumors and cancer.

Surveys indicate women often delay hysterectomy for benign conditions due to fear of pain, scarring and a long recovery time. Those diagnosed with cancer face the prospect of recuperating from surgery even as they undergo other treatment.

Robotic hysterectomy changes the picture dramatically. It gives women a better recovery experience, getting them out of the hospital and back to normal with less interruption of their lives.

Scarring is minimal because the surgery is conducted via a few one-centimeter holes, instead of a long incision. Hospital stays are usually 24 to 36 hours, compared to three to seven days. Full recovery takes two to three weeks instead of two to four months.

Robotic surgery creates options 

Surgery is always an important choice, especially when cancer strikes. Ingham Regional Medical Center’s robotic surgery program is focused on delivering excellent clinical outcomes and getting patients back to their families, leisure activities and jobs more quickly.

At Ingham, mid-Michigan residents have access to some of the most advanced robotic technology and an experienced group of 12 surgeons, including experts in general surgery, cardiothoracic surgery, urology, obstetrics and gynecology, and gynecologic oncology. Robotic surgeons have performed nearly 500 surgeries at Ingham since January 2008 and our program has the most active gynecologic caseload in Michigan.

A generation ago robotic surgery seemed futuristic. Today, robotic surgeons at Ingham Regional Medical Center are making history.  

 

		Dr. Douglas Pugmire is director of robotic surgery at Ingham Regional Medical Center. Pugmire is one of two gynecologic oncologists in the area and holds the distinction of being the most active gynecological robotic surgeon and the second most active robotic surgeon in Michigan. Dr. Craig Nicholson is a robotic surgeon and urologist. Visit irmc.org to learn more.