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Tiny arms, tiny incisions, big payoff

Town & Country Hospital has hired a robot that's a smooth operator and a surgeon's best friend.

By JACKIE RIPLEY
Published January 21, 2005

TOWN 'N COUNTRY - A robot developed by the military to treat battlefield casualties has found its way into civilian operating rooms. And now doctors at Town & Country Hospital are using it to perform everything from prostate surgery to hysterectomies.

"It's awesome," said Dr. Osvaldo Padron, a urologist at the hospital who has performed more than a dozen surgeries using the da Vinci surgical system. "It's like operating with a microscope, only magnified by 10 times."

The $1.2-million surgical system, named for the 16th century Italian painter and inventor, allows doctors to operate through centimeter-sized incisions. Its robotic arms hold tiny instruments that enter the body through those incisions.

The doctor, across the room at a console, views a three-dimensional image of the surgical site. Then, with hand controls, the surgeon uses the same skills and motions that he would use during traditional surgery. The da Vinci system transfers those movements to robotic arms, which mimic the movements to perform the surgery. The robot can perform numerous surgical tasks, such as cutting, sewing and grasping.

The robot's "wrist turns just like on your own hand, only better," Padron said.

Doctors say that kind of flexibility makes it easier, for instance, to reconnect the urethra to the bladder during prostate surgery, reducing the chance of incontinence. And its intense magnification allows for more precision in preserving nerve bundles, lessening the chance of impotency.

Other benefits include reduced trauma to the body, less anesthesia and postoperative pain, shorter hospital stays and less scarring.

"It can make a good surgeon great and a great surgeon fabulous," said Kelly Ferguson, the hospital's chief nurse of operating services.

Robotic surgery has some disadvantages, though. The operation can take longer to perform, and many doctors prefer retaining their sense of touch during surgery.

And it has not been without controversy.

In October 2002, a man died at St. Joseph's Hospital when a doctor using da Vinci accidentally cut two of his main blood vessels. The man's wife sued the hospital, saying the doctors who performed the surgery had not been properly trained on da Vinci.

At Town & Country Hospital, doctors must first be trained in laparascopic surgery before advancing to robotic surgery, Padron said.

Laparascopic surgery, which is similar, is performed through multiple small incisions using specially designed surgical instruments and viewed through a laparoscope, or surgical telescope.

The da Vinci system, which is being used by at least three other hospitals in the Tampa Bay area, was approved by the Food and Drug Administration for prostate surgeries in 2001. It can assist with open-heart surgery and other procedures.

"It's an awesome step forward," Padron said. "We live in exciting times. This sort of thing keeps you young, keeps you learning."

Jackie Ripley can be reached at 813 269-5308 or ripley@sptimes.com

[Last modified January 20, 2005, 08:52:11]