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3-D Imaging is Hallmark of Next Generation of Minimally Invasive Surgery

Thursday, October 23, 2003

This system truly enhances the images and it is dramatically better. The magnified 3-D images improve the accuracy and precision.

Surgeons at Strong Memorial Hospital and the James P. Wilmot Cancer Center are the first in upstate New York to utilize high-tech robotic systems to ensure greater precision while performing surgery to remove cancerous prostate tumors.

This technology provides surgeons a three-dimensional view inside the body as they remove the prostate, giving them the feel of an open surgery while performing a minimally invasive procedure.

“This system truly enhances the images and it is dramatically better.  The magnified 3-D images improve the accuracy and precision,” says Jean V. Joseph, M.D., urology surgeon. 

Prostate cancer is the second most common form of cancer in men, behind skin cancer.  This year more than 220,000 U.S. men will be diagnosed with the disease and one in six men will face it in their lifetime.

Surgical removal of the prostate has long been the “gold standard” treatment for men with cancer confined to the prostate gland, an organ about the size of a walnut and located between the bladder and urethra which contributes fluids to semen.

Strong recently added the daVinci Surgical System to allow urology and cardiac surgeons to offer the procedures laparoscopically, eliminating the need for large incisions. 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 virtual images provided by laparoscopic cameras.

The benefits of the technology have a significant impact on patients and their outcomes. Because the cases are done laparoscopically, dime-sized incisions are made that result in faster recovery time and a lower chance of infection 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.

“It gives the appearance of being inside the patient,” says surgeon Edward Messing, M.D., chair of the Department of Urology. “The three-dimensional view provides a depth perception that is missing in traditional laparoscopic surgery. This brings us as close to the surgical site as we can get.”

Joseph and Erdal Erturk, M.D., have been using laparoscopic techniques for urologic surgical procedures for the past three years to repair damaged kidneys and remove cancerous tumors. 

The robotic system offers surgeons the flexibility and visuals of traditional “open” surgery with fewer complications for the patient. It also enhances the accuracy of delicate maneuvers such as repetitive stitching and suturing, says Messing.

“It’s like comparing a sewing machine to hand stitching.  The robotic system enhances the surgeon’s precision,” Messing says.

The daVinci Surgical System has been incorporated into the new operating room facilities at Strong Memorial. Patients are positioned as they would be during laparoscopic surgery, with medical personnel surrounding them, yet a surgeon is located at a console a few feet away.

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 that mimic the dexterity of the human wrist. Each instrument has a specific surgical mission such as clamping, suturing and tissue manipulation.

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.

The Wilmot Cancer Center is a leader in cancer care and research in Upstate New York. 


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Leslie White

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