August 19, 2008
The robotic da Vinci Surgical System is helping to improve clinical outcomes and redefine standards of care.
When Wayne Lougheed needed surgery for prostate cancer, he wasn't too surprised when his urologist told him one of the options was letting a robot get involved in his procedure.
"I knew the benefits of less invasive procedures," he said, "And I was more than willing to try it."
Of course, he went home and looked up information about the robot on the Internet before proceeding. What he saw impressed and reassured him so much that he made an appointment with board-certified urological surgeon Al Borhan, MD.
Dr. Borhan not only has extensive experience with robotic surgery, but teaches it to other physicians throughout the western United States. Dr. Borhan also impressed Wayne.
A Less Invasive Alternative to Open Surgery
The da Vinci robotic surgical platform has the power to transform how John C. Lincoln surgeons perform complex surgeries.
Wayne's operation, the first robotic surgery at John C. Lincoln North Mountain Hospital, proved to be everything he had hoped for.
It was performed much less invasively than traditional "open" prostate surgery. Even though major work was done beneath the skin, Wayne only has a handful of tiny nicks to indicate anything happened.
Additionally, Wayne's recovery time was much quicker, thanks to the four-armed precision of John C. Lincoln's new state-of-the-art da Vinci Surgical System.
"I had no pain medications — zero pain after I woke up after surgery," he said. "I was amazed at how good I felt. I was actually up and walking in the hospital on the morning after my surgery. I have the pictures to prove it!"
Now, Wayne is waiting somewhat impatiently for his internal healing to catch up with his external sense of well-being.
"I asked Dr. Borhan if I could ride my bike or swim, but he said I should wait about six weeks. But I was back at work less than a week after my surgery. This is the only way to have this kind of surgery done."
Adding a New Dimension to the Surgical Field
Wayne's experience was made possible because John C. Lincoln's surgeons at the North Mountain Hospital have a new $2 million partner to help them perform minimally invasive procedures, starting with prostatectomies and hysterectomies. Future surgical applications range from cardiothoracic to oncologic.
All of the surgeries performed with da Vinci's assistance are what's called "laparoscopic," which means they're done with the assistance of a miniature video camera that is actually attached to one of da Vinci's four arms.
Usually the camera transmits two-dimensional video — a traditional television image — to a monitor in front of the surgeon who's operating through tiny incisions adjacent to the camera.
In da Vinci's case, however, a "Wow!" factor is associated with the video. First of all, its high-definition image is magnified up to 10 times the actual size. In addition, it's three-dimensional. The surgeon can actually see the tiniest details of the patient's anatomy, in perspective.
"In times past," Dr. Borhan observed, "surgeons were taught to keep their heads away from the surgical field. You couldn't have great vision and a sterile field at the same time. Now, with da Vinci, the great thing is that we can. With magnification and HD, the view with da Vinci is great!"
A Completely New Way to Operate
Using the da Vinci, surgeons operate seated comfortably at a console next to the patient while viewing the magnified image of the surgical field. The surgeon's fingers grasp the master controls below the display, with hands and wrists naturally positioned relative to his or her eyes.
According to Al Borhan, MD, pictured with da Vinci, robot-assisted surgery offers the potential to improve patient outcomes and help minimize surgical risks.
The system seamlessly translates the surgeon's hand, wrist and finger movements into precise, real-time, minimally invasive movements of laparoscopic surgical instruments inside the patient.
The da Vincis advanced set of features includes its extensively jointed EndoWrist instrumentation, which provides flexibility that far exceeds the natural range of motion of the human hand and wrist.
It is designed to scale, filter and translate the surgeon's hand movements into smaller, more precise motions of the wristed surgical instruments. This enables surgeons to perform complex procedures through 1- to 2-centimeter incisions.
Many laparoscopic surgeries that use standard techniques today may be performed more quickly, safely and easily with da Vinci, because it delivers increased clinical capability while maintaining the same "look and feel" of open surgery.
Wide-Ranging Patient Benefits
By enhancing surgical capabilities, the da Vinci Surgical System helps to improve clinical outcomes and redefine standards of care. Patients generally experience less trauma to the body, reduced blood loss and need for transfusions, less post-operative pain and discomfort, less risk of infection, shorter hospital stay, faster recovery and return to normal daily activities — and less scarring.
"The acquisition of the da Vinci enhances the great foundation John C. Lincoln already has established for its surgical services," said Dr. Borhan.
"Here at John C. Lincoln, we've established a multidisciplinary approach — we have trained surgical teams, an action plan and a clinical committee to guide future progress," Dr. Borhan said. "This foundation is essential to maximize the value of the da Vinci to our patients."
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