With robot-assisted surgery, 'assisted' is the operative word

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Deanna Mansker

From package-delivering drones to burger-flipping fry cooks, robotic technology has quickly found its way into the American workplace - including the operating room.

It has been more than 10 years since Beaufort Memorial Hospital became the first healthcare provider in the area to offer surgeries with the da Vinci, the most widely used robotic surgical system in ORs today.

But even now, I still find myself explaining to patients that it is the surgeon, not the robot, that will be removing their gallbladder or performing their hysterectomy.

While the technology continues to improve, we are not yet at the place where robots can perform surgical procedures for us. It is still the surgeon doing the work and running the show. The robot is merely a tool that allows the surgeon to more safely perform difficult operations.

In robotic surgeries, the doctor sits at a computer console a few feet from the operating table, directing the movement of the robot's wristed instruments using foot and hand controls. The computer's high-definition visualization allows the surgeon to see the surgical site magnified and in 3-D instead of as a flat image. Seeing better is always safer.

In addition, the robot instruments are able to bend and flex with greater dexterity than a human wrist, making it easier, and thus safer, for surgeons to work in difficult areas where there is little room to maneuver.

Without the improved visualization and extraordinary precision of a robot, these complex operations sometimes have to be performed through a much larger opening instead of laparoscopically through small incisions no more than an inch long.

Robotic technology featured in the latest generation of the da Vinci has become so advanced, some surgeries can even be performed through a single incision. At Beaufort Memorial, gynecologists are using the state-of-the-art technology to perform single-site hysterectomies.

General surgeons at BMH are also using the da Vinci to perform a variety of other procedures, including Nissen fundoplication for the treatment of severe acid reflux disease.

While the operation can be performed laparoscopically, it's very technically challenging to do because the surgeon has to suture inside the body. (It's like using chopsticks to tie a knot.) You're working around a lot of critical structures like the heart, lungs and esophagus, so it helps to have an instrument that allows you to be more precise.

The da Vinci is also used to perform gynecological procedures; ventral and inguinal hernia repairs; partial nephrectomies, an organ-sparing procedure for kidney cancer patients; and colon resection, which involves the removal of part or all of the colon to treat various diseases.

For the patient, robotic surgery means a quicker recovery, reduced risk of infection and less pain, blood loss and scarring. As the technology continues to evolve, we'll look at ways to expand its use, improving patient outcomes.

Deanna Mansker, MD is a board-certified general surgeon with Beaufort Memorial Surgical Specialists. She sees patients in both Bluffton and Beaufort.

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