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Robot gives Mercy surgeons an edge

For certain procedures, da Vinci offers greater precision, less trauma

A surgeon-controlled robot used widely in prostatectomies and hysterectomies – and increasingly in heart-valve repair – is the latest in high-tech health care to arrive at Mercy Regional Medical Center.

The da Vinci robot, operated from a console, offers minimally invasive surgery that reduces patient trauma, blood loss, recovery time and risk of complications.

The availability of the robot in Durango will save patients from traveling at least as far as Montrose or Albuquerque for prostate surgery.

Jim Duresky was knocked for a loop by the news; he is the coordinator of the Man to Man Prostate Cancer Support Group that meets monthly in Durango.

“This is fantastic,” Duresky said. “I’m tickled to death.

“The arrival of this technology to Durango means patients won’t have to leave,” Duresky said. “I hope all urologists here can become competent in the use of the da Vinci.”

A form of laparoscopy (insertion of surgical instruments into the body through small incisions), the da Vinci robot will be used, for the time being, at Mercy by urologists Dr. Sejal Quayle and Dr. David Sisul in prostatectomies.

Overall, laparoscopy is used for 140 procedures in 10 medical specialities, said Hassan Campbell, a da Vinci sales manager from Colorado Springs who covers five states.

Nationally, 87 percent of prostate surgeries is done robotically, Campbell said. Robotic surgery is used in 40 percent of benign hysterectomies and 70 percent of cases involving malignancy, he said.

The robot is manufactured by Intuitive Surgical, headquartered in Sunnyvale, California.

The da Vinci uses a suite of closely grouped stations: a console from which the surgeon manipulates instruments, the robot at the patient’s bedside and a three-dimensional color monitor. The surgeon’s assistant keeps an eye on the robot and the monitor.

During surgery, a patient lies under a four-armed apparatus that could leap from the pages of a science-fiction novel. One arm supports a camera that guides the surgeon. The other arms support instruments that have seven planes of motion – one more than the human hand.

The camera and instruments are guided through sleeves into the body through tiny incisions. There may be five or six.

A few feet away, the surgeon sits at a console to guide the instruments. Two safety features guard against any untoward event. The surgeon first must break an infrared beam when inserting the head into the viewer, then, secondly, click the handles that operate the instruments.

Without those motions, nothing moves. Removing the head from the viewer at any time breaks the circuit.

The surgeon can choose 10-power to 40-power magnification of the work at hand.

By way of demonstration, Campbell displayed the reverse side of a penny on which the Lincoln Memorial is engraved. When he increased magnification tenfold, Lincoln himself can be seen among the pillars.

Surgeries are videotaped to allow postoperative critique.

The da Vinci is light-years improvement over the instruments that bridged the gap between the old scalpel days and robotic surgery, Sisul said.

“The prerobotic instruments weren’t as good as the human hand,” Sisul said.

Mercy acquired the da Vinci robot in the spring from a sister member of Denver-based Catholic Health Initiatives, Mercy spokesman David Bruzzese said. The Mercy Health Foundation footed the cost of transportation and some upgrades, he said.

Out of the box, the price of the da Vinci is $1.75 million.

Physicians learn the secrets of robotic surgery as applied to prostate cancer through dry runs in the laboratory and then working on pigs, Quayle said.

She has performed two interventions with the da Vinci and has four more in the queue.

Sisul, who arrived at Mercy three weeks ago, has 100 da Vinci surgeries under his belt.

The age of robotic surgery has arrived, Quayle said.

“Open surgery is not bad, but if you watch a video of a robot at work, it’s hard to say no to an easier way,” Quayle said. “Why choose an inferior way?”

daler@durangoherald.com



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