With minimally invasive surgery now the norm, and with hospitals' robotic-assisted surgery suites busier than ever, advances in surgery are being measured not only by leaps and bounds but also by inches.
That's because when performing surgery with the da Vinci Si Robotic Surgical System®, the surgeon needs to make only four small incisions, just an inch or so long, to access the site and do the procedure. In robotic surgery, the surgeon can use instruments that provide a range of motion not possible with the human hand, allowing procedures to be done in small, tight places. High-defintion cameras with 3-D visualization provide 10 times magnification to the surgical site. "As surgeons we are able to do so much more when using da Vinci's precision technology and enhanced visualization," says gyn oncologist Dwight Chen, MD. "This leads to better clinical outcomes and higher patient satisfaction. Patients feel less pain, lose less blood, have less risk of infection and are able to recover faster, go home earlier,return to work and resume their lives."
Fewer incisions may be needed in future robotic-assisted surgery. During a single-site robotic cholecystectomy (gall bladder removal), the only such procedure approved so far by the FDA, the surgeon accesses and removes the gall bladder through a 1-inch single incision in the belly button. Surgical instruments plus a camera are inserted using a specially designed port device. General surgeon Klaus See-Tho was the first to perform the new single-site procedure at the hospital this past October.
At El Camino Hospital, robot-assisted surgery is used extensively in gynecology and gyn/oncology surgery as well as in urologic surgery. Da Vinci-trained surgeons are also performing thoracic, colorectal and cardiovascular surgery assisted by the robot. With three da Vinci Surgical Systems, 27 surgeons doing robotic-assisted surgery at both the Mountain View and Los Gatos campuses, several more completing training in general and bariatric surgery, and with the area's only program director, team of nurses and technicians dedicated solely to robotic surgery, the program has become one of the highest-volume robotic programs in the Bay Area. Because the hospital has the highest volume of gynecology and gyn/oncology procedures in Northern California, Intuitive Surgical, makers of the da Vinci robot, designated El Camino Hospital as a Northern California gynecological oncology case observation site for physicians.
This past November, the 500th surgery for the year was completed, and the 2,500th robotic-assisted surgery is expected this month. High volumes are one of the defining hallmarks of an excellent robot surgery program, says Robotics Program Director Randy Creamier, a six-year veteran in the field. “When considering robot-assisted surgery, one of the most important guidelines for patients is volume. High volumes, both for the physician and for the hospital, are key standards of quality in this type of surgery. At El Camino Hospital, we have the perfect combination—the latest technology; a high number of da Vinci trained surgeons doing a high volume of work with more being added all the time; and a highly functioning, specialized team. Patients should feel very confident when choosing our hospital for robot-assisted surgery."
- Robot-assisted procedures at El Camino Hospital's two campuses: 62 per month.
- Ratio of robotic surgery to traditional surgery at the hospital has increased in two years from 50/50 to 65/35 currently.
- The hospital does the highest volumes of robotic-assisted gynecology and gyn/oncology surgeries in Northern California with Drs. Dwight Chen and Albert Pisani accounting for 391 and 729 cases,respectively.
- Nationwide the percentage of traditional surgery hysterectomies ranges from 40 to 55 percent. At El Camino Hospital, the percentage is 15 to 20 percent.
- The hospital's first robotic surgery, a prostatectomy, was done in 2007 by urologist Dr. Frank Lai. Today, more than 80 percent of prostatectomies are performed at the hospital using the robot.
- Surgeons who perform robotic surgery wishing to hone or add to their surgical skills can now do so with the da Vinci Skills Simulator purchased with an El Camino Hospital Foundation grant. A variety of exercises included in the simulator program let surgeons practice as much as needed to become comfortable with new techniques.
- Surgeons utilizing the robot are now able to use a special instrument during surgery to seal vessels, allowing greater surgical precision and control, which leads to better outcomes.
- Early this year, surgeons will begin using the newest daVinci instrumentation: a robot-assisted stapler for bariatric surgery procedures.