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July 11, 2006 > Breakthroughs in Robotic Surgery

Breakthroughs in Robotic Surgery

by Washington Hospital

It may sound like science fiction, but it’s not.  Surgical robots, first introduced in the year 2000, are becoming more and more common in operating rooms.  They’re also being used to perform an increasingly wider array of surgical procedures.

“We use robotic equipment called the da Vinci Surgical System, developed by Intuitive Surgical in Sunnyvale,” says Dr. Sang Lee, a thoracic surgeon at Washington Hospital.  “The robot doesn’t actually perform the surgery on its own, of course.  A human surgeon controls the surgical robot.” 

Working from a control panel, the surgeon directs the da Vinci system to make three 1.5-centimeter incisions – roughly the diameter of a pencil – and then insert stainless steel rods into the body.  One rod contains a camera that transmits three-dimensional images from inside the body to a viewfinder on the control panel. The images show the surgical site and the finger-like instruments mounted on the tips of the other two rods.  While viewing the images, the human surgeon uses controls resembling “joysticks” to manipulate the surgical instruments remotely.

“The robotic system allows us to use very small incisions for surgeries that otherwise would require much larger incisions,” Dr. Lee explains.  “The advantages of such minimally invasive surgery include less pain after surgery, reduced blood loss, a lower risk of infection and a faster recovery.”

With these types of minimally invasive surgery, patients’ hospital stays are often reduced from about one week to as little as one day. Instead of being incapacitated and unable to work for six to eight weeks after surgery, people can often return to work in about two weeks.

Dr. Ramsey Araj, medical director of the Institute for Minimally Invasive and Robotic Surgery at Washington Hospital has converted nearly 80 percent of his surgeries requiring large incisions to laparoscopic or endoscopic procedures. Dr. Araj is also one of the first surgeons to use robots in performing minimally invasive surgery for patients suffering from gastroesophageal reflux disease (GERD).  People with GERD have severe, chronic heartburn that can’t be controlled by lifestyle changes or medication.

Until recently, robotic surgery was used mostly for procedures such as prostate surgery, tubal ligation, hysterectomy, hiatal hernia repair, gall bladder surgery and colon surgery. The latest breakthroughs in robotic surgery, though, are in cardio-thoracic (heart and chest) procedures.

“Robotic surgery can be used to perform general thoracic procedures such as removal of lung or chest tumors,” says Dr. Lee, who completed certification training in the use of the da Vinci system as well as a fellowship in thoracic surgery.  “We also can use it for single coronary artery bypass surgery and to treat heart arrhythmia or fibrillation.”

Dr. Lee notes that several cardio-thoracic surgeries already have been performed at Washington Hospital.  “Robotic surgery is not appropriate for all cardio-thoracic cases, however,” he adds.  “We have to carefully evaluate the patient’s risk factors for such procedures.  For example, the patient can’t have too much fatty tissue that could obscure the camera’s view or manipulation of the surgical instruments.  Also, previous conventional surgeries in the same area where additional surgery is required might preclude the use of robotics.”

To find out more about surgery options through Washington Hospital’s Institute for Minimally Invasive and Robotic Surgery, call (800) 457-4090 or visit, click on “Services & Programs,” and select “Institute for Minimally Invasive and Robotic Surgery.”

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