Surgery is not typically a cause for excitement, but Memorial Hermann Greater Heights has joined the wider trend of attempting to provide patients an alternative option which could result in speedier operations — always a fan favorite.
Memorial Hermann Greater Heights Hospital recently introduced the DaVinci robot-assisted surgery to its patient options, with the first operation taking place May 15. In a robotically-assisted procedure, the surgeon uses the machine to manipulate instruments, allowing for attempts at more precise control on actions such as incision and removal in contrast to typical “open” surgery.
With the robot, Dr. Jorge Leiva, a general surgeon affiliated with Memorial Hermann Greater Heights Hospital, said surgeons operate through a few small incisions following a few specifically placed ports of general anesthesia. The surgeon sits at a console (normally inside the room) and slips their fingers into small sleeves and operate via a 3-D image magnified 10 times the normal view.
“It’s just another way of doing what you can do with laparoscopic surgery, with minimal invasion and incision,” Leiva said. “Most of what we’re doing at this point is extrapolating the laparoscopic techniques into robotic techniques. We have been able to identify which parts of the procedure we can do better with laparoscopy alone and which can be done better with the robot.”
Leiva said the robot’s wristed instruments allow surgeons enhanced dexterity and control not typically humanly possible over the course of an operation. The robot’s multiple arms (one for the camera and three for holding surgical instruments) rotate, extend and retract on multiple joints akin to fingers.
“You have instruments that can take any different angle and any rotation that you typically could not achieve with the laparoscopic,” Leiva said. “You can suture with your forehand or backhand, so it makes you ambidextrous.”
Having done robotic surgeries for about four years, Leiva cautioned that, depending on the surgeon’s training, there is a learning curve, thus many procedures will take a little longer at the beginning. However, he said in many cases the robotic surgery could likely become a speedier, more efficient solution than open surgery.
“For general surgeons, we have surgeries that we do in all four parts of the abdomen, and you have to anticipate what your needs are going to be with your port placement, and that made it more difficult for us at the beginning,” he said. “Depending on what region the surgery is in, it’s easier for us to do it with the robot as opposed to laparoscopically.”
He said many have taken to the promise of such an operation being minimally invasive, which is usually associated with a shorter recovery, less post-op pain and cleaner incisions on procedures that can potentially be very complex, minimizing bigger incisions.
“They start to see the benefits, so we’re starting to see a shift over to where the patients are pushing for these surgeries to be done robotically,” he said. “There’s the perception that this is a much more sophisticated or contemporary way to do surgery, and they’re beginning to ask.”
Educated public a key
When the technology was first introduced, Leiva said the emphasis was on surgeons telling patients whether typical (open) surgery or robotic-assisted surgery was their best option. However as the volume of robotic-assisted surgeries have spiked, he said there has been a monumental shift in landscape.
“This eventually migrated into the desires of the surgeon to operate this way, and it used to be where we told the patient we would like to do surgery robotically, and explain what we could offer to them,” he said. “But that has grown to the point where some of the patients have become educated and very proactive in getting all of the information.”
Many patients, according to Leiva, are now proactive in looking at the reviews (of the surgeons) online and reviewing the possible pros and cons of robotically—assisted surgery.
“As long as you can make sure that you’re doing the same surgery you could be doing open, the patient’s safety is not compromised and that your outcomes are good, I think this is definitely a tool that can offer patients more efficient ways that are safer, with faster recoveries,” he said.