Robots add precision to surgery techniques

AMARILLO, Texas - It sounds like something from a science-fiction novel: A machine helping a doctor operate on a human patient.

But supporters of the technology praise it and call robotic-assisted surgery the greatest advance in minimally invasive surgery in 20 years.

Patients see decreased hospital stays and recovery time, less blood loss and fewer complications.

Robotic-assisted surgery provides doctors with greater range of motion and vision through three robotic arms and a camera.

One Amarillo, Texas, hospital will house such a machine.

The Sunnyvale, Calif.-based Intuitive Surgical delivered the $1.8 million da Vinci Surgical System to Baptist St. Anthony's Health System on Thursday. Surgeons will perform the first surgery by the end of the month.

"For a community of this size, this is a giant leap forward," said Dr. Sean Tedjarati, Harrington Cancer Center oncologist and Texas Tech University Health Sciences Center associate professor of gynecologic oncology.

Because only three or four dime-sized incisions are made for the machine's arms rather than a single 5- to 10-inch cut, hospital stays turn to one day from three or four. Recoveries are reduced from four to six weeks to returning to work in one week.

The machine's thin arms, which rotate 360 degrees, are steadier than even the surest of surgeon hands.

As many as three arms hold surgical tools, while a fourth arm holds the camera.

Through the camera, the surgeon can view a three-dimensional image that's up to 10 times the size of what he's operating on.

A surgeon controls the surgical instruments in the patient's body with his hands and feet at the console several feet away from the patient's table.

"It allows me to mimic what I do with my hands and wrists," urologist Dr. David Wilhelm said.

The increased precision means less trauma during surgery and shorter recovery times, Wilhelm said.

Tedjarati said the equipment will slowly replace many traditional forms of minimally invasive abdominal surgery, such as radical hysterectomies, treating cervical or uterine cancer, removing a person's lymph nodes and thyroid glands, and untying a woman's fallopian tubes.

The technology should allow doctors to perform surgeries that are difficult with traditional methods, meaning patients don't have to travel to larger cities for treatment.

"You can do these cases now, but they're much more difficult," said Dr. Robert Kauffman, Texas Tech University associate professor of obstetrics and gynecology.

There are some disadvantages to the machine. Kauffman said doctors must overcome a learning curve to use the equipment, and operations take longer, increasing the risk for complications during surgery.

There are more than 500 such machines in the country, according to Intuitive Surgical.

Tedjarati stressed implementing the technology would be a slow process.

Surgeons must be trained to use the equipment and need time to become familiar with it.

"To have a successful program we need to move safely, surely and select the right patients," Tedjarati said.