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Advances in Robotic Surgery

Surfing is a huge part of Charles Scalice’s life. So when the Seal Beach resident was diagnosed with cancer in February 2012, he searched for the least invasive treatment option, one that would give him the best shot at a good outcome and allow him to get back on his board as quickly as possible.

Like hundreds of thousands of other Americans, Scalice chose robotic surgery. After undergoing the procedure at UC Irvine Health, Scalice is now free of rectal cancer and back riding the waves at Sunset Beach.

"I believe in robotic surgery,” Scalice said. "I've had surgery before and I know what it's like to be cut open."

Widely introduced in 2003, the minimally invasive da Vinci robotic surgical system has revolutionized a range of procedures — most notably urological, gynecological and colorectal. While da Vinci still dominates the robotics field, Titan Medical is looking to carve out its own niche targeting ear, nose and throat operations with its smaller Sport system, due in 2015. Robotics is even expanding to other treatments such as the robot-controlled proton radiation delivery system at Loma Linda University Medical Center.

“The benefits of minimally invasive surgery are enormous,” said Dr. Naghmeh S. Saberi, assistant clinical professor in UC Irvine’s Department of Obstetrics and Gynecology. “It decreases the time the patient is in the hospital, recovery time is much faster, there is no large incision to heal or major scars, and patients can return to work or their normal lifestyle more quickly.”

Here’s how it works: Specialized surgeons, not robots, guide the procedures by hand movements while viewing a high-resolution 3-D image of the surgical site on a computer console. Small instruments and cameras — inserted into the body through small incisions — are precisely controlled by robotic arms. The tiny instruments and arms can go where human hands can’t, and the imaging improves on normal eyesight.

Originally conceived as technology that could someday allow surgeons to perform operations from hundreds of miles away via satellite link, robotics continues to evolve. The new generation, the da Vinci Si HD, allows two surgeons to work together on separate consoles, able to switch control at any time during more complex surgeries.

City of Hope in Duarte recently introduced a process  that makes healthy tissue glow, enabling the surgeon to more precisely target malignant masses during robotic surgery while minimizing damage of surrounding tissue, said Dr. Timothy Wilson, head of urology and urologic oncology at City of Hope. A dye is infused into the patient’s blood, and a near-infrared light illuminates the tissue on screen.

“Diseased tissue shows up dark and grayish,” Wilson said. “But healthy tissue shows up bright green when exposed to the light.”

In the near future, look for robotic technology to continue to evolve, becoming even less invasive,  requiring smaller and fewer incisions, with increasingly high-resolution imaging, Wilson said.

 

Robert Young

Brand Publishing Writer

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