Attention, guys: If you are planning to have your prostate removed any time soon at the Hospital of Saint Raphael, look for a robot to be lending an arm. Or four.
Dr. Thomas Martin may well be the pilot—aka surgeon—manning the new robotic craft performing your procedure.
And after he and his new da Vinci Si HD robotic pal (pictured together above) remove your prostate, they’ll reconnect your urethra to your bladder with 24 perfect little stitches.
Saint Raphael’s pioneered the first robotic surgery program in the state in 2005. On Tuesday afternoon it put on public display one of the most advanced robots to date.
According to Martin, who heads the robotic surgery department, the new da Vinci Si HD system, provides an additional “arm” and vastly enhanced high definition images for surgeons to follow.
It will lead to better outcomes that include shorter surgeries, less blood loss, much finer and securer suturing, and quicker return to functioning.
The technology is suited for working in small confined spaces with poor visibility and where there are lots of blood vessels to be avoided, as in the case of prostate removals and hysterectomies.
Martin, a urologist, said he explains the options of robotic to traditional surgery to patients this way: Why choose “a horse and buggy versus a jet plane?”
In fact the robotic equipment on display in the cafeteria of Saint Raphael’s, Martin said, evolved from military technology. A surgeon who sits at the console is very similar to the highly trained pilot of a drone.
First-year intern Rassull Suarez sat down at the machine Tuesday to practice stacking pennies on black rings, just for fun.
“It felt like [playing] Mario Brothers,” he said.
It is of course very serious business. Surgeons take months to train on the machine and then perform surgeries using it on lab animals before they transition to humans.
The hospital’s latest machine also has training consoles for surgeons as well as a kind of space-age simulator to practice skills on the very machine that they will be flying, that is, using in real procedures.
The machine, which is produced by Sunnyvale, Calif.-based Intuitive Surgical, costs $1.75 million.
A previous version, which had no high definition and one less arm for the surgeon to manipulate, has been used by Dr. Martin and other Saint Raphael’s staff, to perform about 900 operations thus far.
Martin, who briefly delayed a procedure he was performing to discuss the technology, praised the seriously augmented visibility and the fourth arm.
When a surgeon removes a prostate, “You can’t put your eyes into defined, narrow spaces,” he said.
With the miniaturization, Martin is able to make very small incisions. He can also see clearly at very high definition. That helps him avoid blood vessels, which may accidentally be punctured with less sophisticated and larger tools, such as human hands.
When he has removed the prostate, he can reconnect the bladder to the urethra with 24 tiny, precise stitches, as opposed to four larger and imprecisely placed ones, which is the way it has been historically done by hand, Martin said.
“There’s also no tremor,” he added.
For all those reasons, robotic surgeries result in less pain for the patient, shorter lengths of stay, less bleeding, quicker recovery of functioning, he said.
Saint Raphael’s spokesperson Liese Klein said that patients are increasingly sophisticated, do their research, and ask for the robotic procedures.
Saint Raphael’s purchase is an effort to respond to those needs and stay on the cutting edge, as it were.
Martin has supervised the training of 12 Saint Raphael’s surgeons in the use of the da Vinci. He said he thinks that in 10 to 15 years it will be a standard part of all surgeons’ training.
He said the comparison of the surgeon at the console to the pilot of a drone, or remote-controlled aircraft, is accurate.
“It’s exactly like a medical drone,” he said. He added that the technology evolved because “the only people more expensive to train [in the military] than trauma surgeons are fighter pilots.”
The difference is that with military drones all the communication is wireless, whereas so much information is being conveyed that the medical robot is heavily cabled in the operating room.
Martin said he thought one day the medical robot too might be wireless.
The machine is named after the Italian 15th century artist because he built in effect a robotic mechanical knight for for the Duke of Sforza when he, Leonardo, was only 12 years old.
Before he left to begin to operate upstairs, Martin said the cabling on the “needle pusher” instrument at the wrist of one of the robot’s arms—it’s used to push thread through tissue when it comes time to do the sewing up—is not that different from the ropes and pulleys on Leonardo’s 1495 mechanical robot.
Martin said the staff is at the beginning stages of a contest to name their new robot.