Robotics becoming standard in some surgeries

And their use is becoming commonplace in some of the most often-performed surgeries. Surgeons skilled in robotics say that will only increase in coming years.

It has become a standard of care for removing prostates and is making huge inroads in other fields including colorectal, cardiothoracic and gynecologic surgery, according to Dr. John Oglesby, OB/GYN at Salt Lake Regional Medical Center.

Surgeons there are now using the daVinci Surgical System for even routine hysterectomies. They can treat uterine fibroids with it. And it recently became the first hospital in the area to use robotics for a sacrocolpopexy, the surgical treatment for prolapse of the uterus, bladder, vagina or rectum in which a sling is used to do what weakened muscles no longer do.

With the robotic system, instruments are inserted through numerous small ports in the patient's skin. The surgeon sits at a console across the room and, watching with 3D binocular "eyes," uses fingers, wrists and a clutch system to maneuver the devices, including what amounts to an extra arm. Because of its advanced fine motor skills, it can be used for cases that were not doable with the two-dimensional, ping-pong style of a traditional laparoscopy, according to Dr. Jason Johnson, who did the first prolapse case using the robot at Salt Lake Regional.

His patient, Chantelle Le-Gendre, had mesh placed robotically on June 12, was walking hours later and went home the next day. The pain was minimal, she said, and she's now back at work.

What type of surgery — open, laparoscopic, robotic — hinges in part on a patient's anatomical differences. For instance, Oglesby said, it's hard to do laparoscopic hysterectomy on an overweight patient or one who has severe adhesions. With the daVinci, that's no problem, but if the patient is too petite, it may be difficult or impossible to maneuver. Of the 600,000 hysterectomies performed nationally each year, more than 60 percent are still done with a large "bikini" incision.

Both doctors predict the volume of robotic surgeries of all kinds will continue to grow, driven by big advantages, including less bleeding, fewer complications, smaller incisions and less recovery time.

Surgeons are also using daVinci robotics at Intermountain Medical Center, Huntsman Cancer Hospital at the University of Utah and Pioneer Valley Hospital, according to Kristian Pettengill, an area sales manager for the daVinci system. All of them perform prostatectomies, partial nephrectomies and certain complicated hysterectomies. Use for other types of surgeries varies from facility to facility.

Nationally, there are now 800 daVincis in use, he said.

E-mail: lois@desnews.com

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