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Metal, tissue and silicon
Dr. Herkanwal Khaira is seen using the da Vinci Surgical System during surgery on a prostate cancer patient at Queen of the Valley Medical Center. The less-invasive robotic surgeries allow for a quicker recovery time for patients. J.L. Sousa/Register | Buy photos
A robotic surgery shows promise of technology in the OR
Monday, July 07, 2008
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More than ever, technology is a mainstay of our day-to-day routines. On the job and at play, you probably rely on a cell phone, computer, or — to shave prep time from a home-cooked meal — the microwave in your kitchen. But how would you feel if a surgeon enlisted the help of a robot for your next surgical procedure?

If you’re like hundreds of Queen of the Valley Medical Center’s past and current patients, you might just give it a whirl.
On a recent weekday morning, a 72-year-old cancer patient, whose name is being withheld for privacy reasons, entrusted a team of surgeons at the Queen to perform his prostatectomy, or removal of the prostate. The surgical alliance was anything but ordinary, consisting of Dr. James Hendricks, Dr. Herkanwal Khaira and a $1.65 million robot in the form of the da Vinci Surgical System.

In the Queen’s operating room five, the two-man, one-robot team joined forces. After Khaira and Hendricks suited up in surgical scrubs, caps and masks, nurses readied the da Vinci for duty, swathing its thick, steely arms in plastic to ensure a sterile operating field.
Inside the approximately 450-square foot OR, a frenzy of activity erupted and nobody was without a role. Registered surgical nurses, including Judi Buffington, counted, re-counted and recorded the number of surgical instruments stacked on small, metal trays as Dr. Robert Singler, an anesthesiologist, stood watch at the head of the operating table, monitoring the patient’s vital signs. Breezing past, surgeons and staff hastily left and revisited the OR.

Following about 40 minutes of meticulous preparations, Buffington painted the unconscious patient’s abdomen with iodine as he lay on his back.
Next, Khaira and Hendricks made the first incision. It is the entry point for the steady hiss of carbon dioxide, used to inflate the body cavity and afford better access to internal organs. Slowly but considerably, the man’s belly expanded under the da Vinci’s silent bulk.

Getting to work, Hendricks and Khaira made five roughly 9-millimeter incisions into the patient’s abdomen.

As Khaira guided the robotic arms into the incisions, Hendricks sat at the da Vinci’s console at the other side of the OR, controlling the tiny camera, light and scissor-like apparatuses at the ends of the robotic arms. A viewfinder device at the console provided the surgeon with a three-dimensional view inside the body cavity. Simultaneously, a screen suspended near the head of the patient bed provided the same view, but magnified ten times.

As an iPod filled the OR with the tunes of Metallica, Bach, Fleetwood Mac and other artists, the screen offered an ever-changing scene of the delicate scissoring movements of a robot arm attachment, alternately snipping and cauterizing tissue. An additional arm provided suction as a dance of tissue and metal ensued.

Intermittently, the arms were extracted, bathed in a cleansing solution, and gently re-inserted.

The surgery, spanning about five hours, culminated in the removal of the offending gland.

Hendricks said although most prostatectomies require oly two or three hours of robot time, this patient had pre-existing conditions which complicated the procedure.

The future of surgery

The benefits of robotic-assisted surgery are considerable. Traditional, open prostatectomies typically cause about 10 times more blood loss than robotic surgeries, Khaira said, adding that patients who undergo robotic procedures typically lose just 150 milliliters, or about four ounces of blood.

Smaller incisions used in robotic procedures also foster shorter recovery times: while a traditional prostatectomy may require a two- or three-day hospital stay, recovery time for a robotic surgery is typically just 24 hours.

Another of the state-of-the art surgery’s most marked benefits, Khaira said, is patients’ minimized nerve damage following the procedure.

The da Vinci, often used for urological surgeries at the Queen, is manufactured by Intuitive Surgical, Inc.

Bolstered by a private donation, the Queen acquired the system about five years ago, according to Jaime Penaherrera, the Queen’s program director of marketing and communications.

A $250,000 grant from Auction Napa Valley financed an additional robot arm approximately two years ago, he said.
2 comment(s)

steph wrote on Jul 7, 2008 10:31 AM:

" Viva la capitalism! "

jersey guy wrote on Jul 7, 2008 1:00 PM:

" The headline should have said "OR", not "ER". "

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