Race To Arms

March 9, 2010

Doctors are very excited when their hospitals give in, join the new world, and buy the da Vinci robotic surgical system. It's like Christmas and getting a toy made for big people. Surgeon people, that is.

But it takes some time to learn the new robotic surgery techniques. Dr. Del Ashcraft recalls the first time he performed a robotic hysterectomy surgery at Chatanooga's Parkridge East Hospital. It took him over two hours to get the job done.  

Almost God-Like

It takes some practice, but once a doctor has the knack, he feels almost God-like. After performing some 200 robotic surgeries, Ashcraft says he can get through a hysterectomy in an impressive 20-50 minutes. Still, even though he prepared at length for that first robot-assisted surgery he did two years ago, the 44-year-old gynecologist remembers that the procedure he performed was "mentally exhausting."

The middle-aged physician was forced to put aside his conventional ways and adapt to the new technique. Ashcraft describes the learning experience as "intense." The physician viewed an enlarged 3-D real time video image of his patient's abdominal organs as he did the painstaking work of detaching his patient's uterus from its moorings.

Busy, Busy

Ashcraft remained cognizant of the fact that five inches of his own hand's movement translated into a single inch of movement by the robot's hand, which was buried deep down inside the patient's abdomen all the way at the other end of the operating room. Meantime, his feet were busy, too. One foot operated the zoom function on the tiny video camera, while another foot worked a cauterizer that took care of any bleeding blood vessels. As the doctor tied sutures by manipulating the robot's arms, he watched the live video feed to see when blood would cease to seep out of the vessels. That was how he'd know the sutures had been pulled sufficiently tight.

Of course, all this fancy-schmancy equipment doesn't come cheap. A da Vinci system costs $1.7 million and has yearly maintenance fees of another $140,000. But physicians say that the equipment eventually pays for itself.

Shorter Stays

Robotic surgery is minimally invasive so that there is less of a chance of infection or other large incision-related complications. There's less pain after surgery. Patients have shorter hospital stays and get back to their normal lives much faster.

But it's also true that the da Vinci can do more than any human could ever do on his own. The robot can maneuver in ways that laparoscopy cannot. This means that patients have another option to large incision surgery in cases where laparoscopy wouldn't have sufficed. Adam Royer, the executive director of Parkridge's surgical services comments, "With that alone, I think that’s certainly a benefit."

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