Minimally Invasive Surgery Becomes More Patient-Friendly With Use of the Da Vinci Robot

from The Children's Hospital (TCH) News, May 2003

Dr. David Clarke, cardiothoracic surgeon,
demonstrates the new da Vinci robot, which will
allow surgeons at The Children's Hospital to
perform minimally invasive operations remotely.

By using the mechanical arms and eyes of the da Vinci robot, surgeons at Children’s can now perform minimally invasive operations remotely – operations that result in smaller incisions and give patients quicker recovery times.

Additional benefits to patients include: reduced surgical trauma, less blood loss, less anesthesia, less post-operative pain, less risk of infection, shorter length of stay and less scarring.

David Clarke, MD, cardiothoracic surgeon, a strong proponent of the robot, says, “Our investment in the robot positions us as a leader in providing the best health-care outcomes for children. The da Vinci robot allows us to make minimally invasive surgery available to more children by increasing the number of procedures that can be performed with that approach.”

The robot will be used primarily in general pediatric surgery, urology and cardiac surgery in such minimally invasive surgeries as: spleenectomy, pyeloplasty and division of double aortic arch. Ultimately some open heart surgeries will be performed using da Vinci.

Minimally invasive surgeries performed at Children’s have more than doubled in the last few years, from 400 in 1999/2000, to more than 850 in 2001/2002. Currently, minimally invasive procedures represent just five percent of the surgical operations performed at Children’s, but as many as 25 percent of all surgical procedures could become minimally invasive in the next decade. There are more than 150 robotic systems in use in the United States , Europe and Japan . Other leading hospitals that care for children using robot-assisted surgery include Boston Children’s, Johns Hopkins, Children’s Hospital of New York-Presbyterian and the Mayo Clinic.

Surgeon and operating room staff member teams from urology, cardiothoracic surgery and pediatric surgery have attended two-day intensive training courses on the robot at the manufacturer’s headquarters in Sunnyvale , Calif. , or a training laboratory at the University of California at Irvine . During the training, they learned to set up, drape for sterility and properly shut down the equipment, and were able to practice various techniques related to their specialty. “Maneuvers are remarkably easy to learn,” said one surgeon, and another stated at the end of the two days, “We’re ready to ‘go live.’”

Previously, surgeons performing endoscopic surgery have been limited to viewing the anatomy in two dimensions, working with arm-like tools that have limited movement capabilities and have had to stand for many hours while performing the intricate work.

With the robot, surgeons sit in front of a surgical console and have a three-dimensional view to perform the surgery. The instruments that the surgeon manipulates have tiny wrists near the tips that bend in all directions and increase the dexterity and manipulation possible in confined body cavities. Additional benefits include motion scaling that eliminates hand tremor and substantially increases precision.

The presence of the da Vinci robot will aid in the recruitment and retention of surgeons, expand surgical training capabilities, maintain and increase the number of children we treat and enable The Children's Hospital to maintain its reputation as a top children’s hospital.