Hard to believe it was just 30 years ago that a French physician performed the first laparoscopic cholecystectomy, removing a patient’s gallbladder through several small incisions in the abdomen. The procedure launched the revolution of minimally invasive surgery.
Today, robotic technology has taken the dramatic medical advancement a step further, allowing surgeons to operate with enhanced vision, precision, dexterity and control.
|Deanna Mansker, M.D.|
Beaufort Memorial was the first healthcare provider in the area to offer surgeries with the da Vinci, the most widely used robotic surgical system in ORs today. Four years ago, the hospital upgraded to a more advanced version of the system, expanding the number of surgeries that can be performed with the robot.
Procedures that once required open surgery are now being performed laparoscopically through tiny incisions no more than an inch long. For the patient, it means a quicker recovery, reduced risk of infection and less pain, blood loss and scarring.
I am one of three general surgeons at Beaufort Memorial using the robotic technology to perform gallbladder surgery, ventral and inguinal hernia repairs, and colon resection, which involves the removal of part or all of the colon to treat various diseases. I also use the DaVinci system to perform Nissen fundoplications for severe acid reflux disease and hiatal hernias. The da Vinci also is being used for hysterectomies, other gynecological procedures and kidney cancer removal.
The robot does not perform the surgeries. It is a tool we use to make difficult operations easier, and thus, safer. In each of these procedures, the surgeon is 100 percent in control of the robot at all times.
Here’s how it works:
The system is made up of two main parts: a computer console with a viewing monitor and hand and foot controls and a cart with four computer-controlled robotic arms. One arm holds a miniature camera that transmits magnified, high-resolution three dimensional images of the surgical site to the console monitor. The other three arms hold a variety of surgical tools.
At the start of the operation, the surgeon makes a few keyhole incisions in the abdomen of the patient to insert the camera and miniaturized instruments.
Sitting at the console a few feet from the operating table, the surgeon is able to tell the robot how to move and what to do using the foot and hand controls. The wristed instruments bend and rotate 360 degrees, allowing us to pinch, move up and down and left to right with far greater dexterity than our own hands. With traditional laparoscopic surgery, the tools cannot bend.
Using the robot, we are able to work in difficult areas where visualization is poor and there is little room to maneuver.
We’re also able to view things clearer in 3D than with the flat image we get with a standard video monitor. In addition, the system has a zoom capacity offering 10 times the magnification.
Without the improved visualization and precision of the robot, these complex procedures sometimes have to be performed through a much larger opening instead of laparoscopically through a few small incisions.
The technology featured in the latest generation of the da Vinci is so advanced, some surgeries can even be performed through a single incision. At Beaufort Memorial, we now offer single-site hysterectomies and gallbladder surgery.
Originally, gallbladders were removed through a large cut extending from the sternum, along the ribcage, to the back. Recovery from the procedure required a four- to five-day hospital stay. Cholecystectomies took a huge step forward with the introduction of laparoscopy. With just four small incisions in the abdomen, patients could go home the same day.
Now, we can perform the surgery through a one-inch long incision in the belly button, leaving the patient with virtually no scar. Some hysterectomies (the removal of the uterus) also can be performed as single-site surgery.
Robotic surgical systems have been approved by the Food and Drug Administration for cardiac, head and neck and thoracic procedures, as well as prostatectomies (the removal of the prostate). As the technology continues to evolve, we’ll look at ways to expand its use, improving patient outcomes.
To learn more about the benefits of Beaufort Memorial’s da Vinci surgical system, click here.
Deanna Mansker is a board-certified general surgeon with Beaufort Memorial Surgical Specialists. She can be reached at (843) 524-8171.