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Strong Memorial Hospital Tallies 2,000 Robotic Surgeries

Tuesday, December 16, 2008

Surgeons at Strong Memorial Hospital are among the leaders in the use of robotic technology in the operating rooms.

Strong Memorial Hospital robotic surgeons have performed more than 2,000 robotic surgeries, collectively placing the institution among the top 10 in the country for its expertise in this specialized technology. The milestone reflects patients’ growing demand for less invasive surgeries that offer faster recovery and fewer complications.

Strong was first in the region to introduce the daVinci Surgical System in 2003, and since then has added another machine to keep up with patient demand. Highland Hospital also acquired a robotic system earlier this year.

Today, surgeons throughout the University of Rochester Medical Center use the da Vinci robotic system for a variety of procedures including prostate, kidney, bladder and gynecologic cancer surgeries; benign gynecologic and pelvic reconstructive surgeries, and as a minimally invasive way to remove lymph nodes needed to accurately stage these cancers.

According to Jean V. Joseph, M.D., director of the University of Rochester Medical Center’s Urology Section of Laparascopy and Robotics, the majority of cases performed at Strong are prostatectomies, though he sees that expanding.

“We are among the pioneers in the use of this technology,” says Joseph, who also serves as president of the Society of Urologic Robotic Surgery, an international organization dedicated to advancing robotic surgery and credentialing institutions and surgeons. 

“We’re also a leader in terms of training people to perform these surgeries across the country,” Joseph said. “This fits into the Medical Center’s mission of providing outstanding, cutting edge care for our patients -- the less invasive the care the better, we believe -- and also to fulfill our mission of teaching and providing opportunities to learn to provide better care for the society at large.”

Gunhilde Buchsbaum, M.D., director of the Division of Urogynecology and associate professor of Obstetrics and Gynecology, and Urology, says the extensive suturing needed in some gynecologic surgeries – such as tubal reconstruction and removal of uterine fibroids – is enhanced by the robot’s precision.

Buchsbaum uses the robot for nearly all of her abdominal prolapse repairs because it greatly reduces post-operative pain and recovery time for her patients. Previously, when she performed open procedures, patients were hospitalized three to five days and recovered over a six-week period. Using the minimally invasive robot-assisted surgery, most of her patients leave the hospital within 23 hours of surgery and feel able to return to work in just two weeks.

“The recovery is much faster and we’re seeing a dramatic reduction in pain medication,” said Buchsbaum, who performs many pelvic floor reconstructions using the da Vinci system.

The leading-edge technology consists of a robotic arm that performs surgeries using movements that replicate a surgeon’s motions. The movements are controlled from across the room, by a surgeon using 3-D images provided by laparoscopic cameras.

“This system truly enhances the images and it is dramatically better. The magnified 3-D view improves the accuracy and precision,” Joseph said.

The benefits of the robotic technology have a significant impact on patient outcomes. Because the cases are done laparoscopically, dime-sized incisions are made that result in faster recovery time and a lower chance of infection, decreased blood loss or other complications. The procedures themselves can be even more accurate than traditional surgery, with steadier “hands” at the surgical site being directed by a surgeon.

Supporting surgical team members prepare small incisions in the patient, install the correct instruments, and supervise the laparoscopic arms and tools being used.  The instruments are designed with seven degrees of motion to mimic the dexterity of the human wrist. Each instrument has a specific surgical mission such as clamping, suturing and tissue manipulation. The robotic system also enhances the accuracy of delicate maneuvers such as repetitive stitching and suturing.

Although the surgeon is not physically in contact with the patient, the daVinci control console allows the surgeon to actually see the surgical field in enhanced detail as a result of the three-dimensional image transmitted from the laparoscopic cameras. The surgeon manipulates the robotic “hands” in real-time using master controls, seeing minute, 3-D details inside the patient with the aid of the cameras located inside the patient. The two robotic arms and one laparoscopic arm execute the surgeon’s commands.

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Leslie White

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