What’s steadier and more precise than a surgeon’s hands? A robot controlled by a surgeon

The future is right now, at St. Joseph’s Hospital in Bellingham, for anyone needing urological surgery. After years of discussion, PeaceHealth acquired a da Vinci robotic surgery system last September.

The million-dollar device allows for surgeon-operated, minimally-invasive robotic surgery with a slew of potential benefits to both doctors and patients.

The technology has been available to hospitals for about 15 years, but Dr. Ken Bachenburg, chief medical officer of PeaceHealth, says it’s only been in the last year or so that enough area physicians finally have the training needed to utilize the device.

Previously, anyone wanting robotic-assisted surgery would have to travel to either Everett or Seattle. Now, they won’t have to leave Whatcom County.

Bellingham Urology Group and Pacific Northwest Urology Specialists both currently are using the system, and the two operations are making good use of it.

Over 30 surgeries were conducted in the first three months – a number that Dr. Kelly Casperson says was the original estimate for an entire year of use. Casperson, of PNW Urology, says more than 60 surgeries have now taken place.

“It’s so great that… (patients) can stay here, and we can do everything that Seattle can do,” she says. “It’s just taken off.”

How it works

Currently, the da Vinci device is being used for prostate, kidney, bladder, urinary tract and pelvic floor repair surgeries at St. Joseph’s.

Casperson emphasizes that, contrary to misconception, the robotic unit is not performing the surgery itself, and isn’t capable of accidentally removing your gallbladder instead of your kidney.

“We don’t ‘plug and play’ and go get coffee,” she says with a laugh. “A surgeon is still doing the surgery.”

The device works like an extra-precise, extra-small pair of wrists, a series of crane-like arms that hang above the patient. The surgeon puts the surgical instruments – as small as one centimeter (four-tenths of an inch) – into ports on the end of each arm.

Once properly arranged, the surgeon sits in the operating room and uses a control console with a pair of hand-held controls, peering through a three dimensional video screen to conduct the surgery. When finished with the procedure, the surgeon will scrub in, return to the patient, take out the robotic ports and close incisions.

It’s a lot like laparoscopic (minimally-invasive) surgery, Casperson says, only with an even greater range of motion, precision and vision. Sometimes, she adds, it feels almost like playing a video game.

Although each type of surgery varies in benefit from robotic assistance, the surgeries can be quicker and more precise for doctors and less invasive for patients – meaning smaller incisions, less blood loss and pain, a shorter hospital stay and, ultimately, a quicker recovery time.

There is no additional cost to patients versus traditional surgery, Casperson adds.

Expanding use

Coordinating the use of the single machine between two different urology groups has not been a problem, according to Dr. Vernon Orton.

Orton, of Bellingham Urology, moved to Bellingham last year from Richmond, Virginia, and has eight years of valuable experience with robotic-assisted surgery.

He’s performed hundreds of these surgeries, and says their prevalence will likely continuing expanding to other surgical disciplines in Bellingham, such as general surgery or even cardiac procedures.

“I think it’s a huge benefit to the patient,” he said. “It’s working great.”

Casperson, a member of PeaceHealth’s Robotics Committee, says there is interest in the da Vinci machine for general surgery, gynecology and ENT (ear, nose and throat) procedures. However, the high volume of urological surgeries means that other specialties may have to wait to utilize the technology.

This story was originally published April 25, 2017 at 8:13 AM with the headline "What’s steadier and more precise than a surgeon’s hands? A robot controlled by a surgeon."