Wednesday, July 16, 2008

Doctors team with ‘da Vinci’ to perform surgeries

Holy Cross Hospital’s computerized robot allows for minimally invasive procedures, faster recovery times

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Chris Rossi⁄The Gazette
Dr. Albert Steren sits at the controls of the da Vinci robot, which is prepped and sanitized for surgery, on Monday morning at Holy Cross Hospital in Silver Spring. The robot, the first of its kind in use for the general public in Montgomery County, allows for minimally invasive procedures and faster recovery times for patients.
Sitting in front of a computer console Monday morning in an operating room of Holy Cross Hospital, Dr. Albert Steren demonstrated how the four-armed machine beside him would assist him in his first surgery of the day.

‘‘Everything I do, I can do from this chair,” said Steren, the medical director of gynecologic oncology at the Silver Spring hospital.

Directly beside him, the ‘‘da Vinci” robot, a machine with surgical instruments and an endoscope, or lens, attached and controlled by a surgeon several feet away, was sterilized and covered in plastic. Steren, the robot, and a group of hospital staff worked as a team that morning to perform a hysterectomy on a 58-year-old psychologist. The robot is the first of its kind in Montgomery County to assist surgeons in procedures for the general public.

‘‘It’s an incredible way to operate. ... It’s a completely wild experience,” Steren said. ‘‘Over time, much of surgery will be done robotically.”

Holy Cross purchased the robot for $1.5 million last May as a budgetary expenditure, said Yolanda Gaskins, a hospital spokeswoman. While it costs the hospital more to use the robot than laparoscopic surgery, which is a form of surgery using a telescopic lens that involves much smaller cuts than traditional open surgery, none of that cost is passed on to the patient, Gaskins said.

The robot’s arms are controlled by a surgeon at a computer console several feet away from the patient. A microphone is attached to the console so that the doctor may call out orders to his team. Incisions made are the size of keyholes, which doctors said shortens recovery time.

Steren led the first da Vinci surgery at Holy Cross on May 28. Since then, three Holy Cross surgeons have been trained to use the da Vinci, which is named after Leonardo da Vinci, who is credited with designing the first robot around 1495. In total, Holy Cross doctors perform three surgeries using the robot each day, with three hours between each procedure to reprocess the machine, Gaskins said.

Ten hospitals or medical centers are using the da Vinci robot in Maryland, according to the California-based Intuitive Surgical, which distributes the da Vinci for commercial use. All three of the surgeons at Holy Cross are in the women’s health department; a number of Holy Cross surgeons specializing in urology are currently in training, which involves observation, lab sessions and procedures proctored by physicians. The da Vinci has been used nationwide in heart and prostate procedures as well.

‘‘Simplistically, it’s a better laparoscope,” said Dr. James Barter, a gynecology oncology surgeon at Holy Cross who has six surgeries scheduled this week using the robot. Barter said the 3-D visuals provided by the robot and shown on monitors provide better images of the live procedures, and the wrist flexibility the robot allows for makes the machine superior to other surgical tools.

Although the procedures at Holy Cross have been smooth, Barter said doctors have other instruments ready to proceed with surgery if there was any problem.

‘‘There’s no real contact with the patient during the surgery. ... But really, that’s not a detriment,” Barter said. ‘‘It’s about making surgery safer and easier for the patients.”

Silver Spring resident Joycelyn Jones described herself as ‘‘a bit scared” when Steren proposed he use the da Vinci on a surgery to disconnect her uterus last month. All patients must consent to use of the robot. Gaskins said she has not heard of any patients refusing consent.

A native of Guyana, the 50-year-old Jones said she was used to doctors with scalpels and had already undergone a similar procedure more than a decade ago. But she now says she is glad she listened to Steren.

‘‘Everybody was surprised by the way I healed so fast,” she said. Jones spent one night in the hospital, and took about two weeks to heal, she said. By the fourth week, she felt no pain.

‘‘Compared to my first surgery, it was much better,” she said. ‘‘It took me three weeks [then] to even walk on my own.”