2006 Press Releases
Introducing the Next Frontier of Minimally Invasive Surgery Monmouth Medical Center Becomes First and Only Hospital in Region to Implement Robotic Surgery LONG BRANCH, NJ, JULY 12, 2006 - Monmouth Medical Center, one of New Jersey’s largest academic (university-level) medical centers, has become the first and only hospital in Monmouth and Ocean Counties to implement the next generation of minimally invasive surgery with the da Vinci® S Surgical System. The da Vinci S Surgical System combines computer and robotic technologies with the skills of a surgeon to create a new category of surgical treatment. making it possible to treat a broader range of conditions using a minimally invasive approach. By enhancing surgical capabilities, robotic surgery is helping to improve clinical outcomes and redefine standards of care. The da Vinci S Surgical System provides surgeons with an alternative to both open surgery and traditional laparoscopy, allowing surgeons to perform even the most complex and delicate procedures through very small incisions with greater precision, superior visualization, enhanced dexterity, and ergonomic comfort for the optimal performance of minimally invasive surgery. The advanced feature set and extensive Endo Wrist® instrumentation of the System enables surgeons to overcome the significant technical drawbacks of traditional laparoscopy such as the fixed-wrist instruments that limit the surgeon’s dexterity. As a result, some of the more technically demanding surgeries, such as a prostatectomy, where conventional open surgery is the standard approach, can now be performed with a minimally invasive approach.
Robotic surgery has become increasingly popular as surgeons seek more advanced ways to perform complex procedures with the least amount of risk and recovery time for patients. While the robots are not true autonomous robots that perform surgical tasks on their own, they are lending a mechanical helping hand to surgeons who use them for unprecedented control and precision of surgical instruments in the least invasive surgical procedures available. The da Vinci Surgical System was approved by the U.S. Food and Drug Administration in 2000, making it the first robotic system allowed inside American operating rooms. Only the da Vinci overcomes the limitations of both traditional surgery and conventional laparoscopy. The system allows the human surgeon to get closer to the surgical site than human hands and vision will allow through its 3-D image of the surgical field and increased dexterity of the EndoWrist instrumentation. The EndoWrist has seven degrees of freedom that allows for increased control and dexterity to manipulate instruments and place sutures in more complex cases than is possible with traditional laparoscopy. As a result, the surgeon’s hand movements are scaled, filtered and seamlessly translated into precise movements. Frank J. Vozos, M.D., FACS, executive director of Monmouth Medical Center, said, “The da Vinci system is a remarkable improvement over conventional laparoscopy surgery. The EndoWrist allows the surgeon to perform more complex procedures such as prostatectomies and hysterectomies with lymph node dissection with a higher level of precision and accuracy than previously available. But it is still the surgeon’s skill and expertise that the patient benefits from; the robot simply works to enhance the surgical procedure.” That’s because the robot’s “arms” eliminate even the smallest, barely noticeable human hand tremors, making movements remarkably steady. The surgeon can scale the robotic movements so that, for example, a five-inch human hand motion moves the robotic hand just one inch. This allows the surgeon to perform extremely precise and complex movements with greater ease. According to Michael Goldfarb, M.D., chairman of surgery at Monmouth Medical Center, the da Vinci S Surgical System allows surgeons to go beyond the current modes of laparoscopic surgery where a surgeon must look up and away from the instruments to a 2-D monitor to see an image of the target anatomy. The surgeon must also rely on assistants to position the camera correctly. “However, in contrast, the da Vinci System’s ergonomic design allows the surgeon to operate from a comfortable, seated position at the console, with eyes and hands positioned in line with the instruments. At the same time, the state-of the-art robotic and computer technologies scale, filter and seamlessly translate the surgeon’s delicate hand manipulations into precise micro-movements of the instruments. Thus, to move the instruments or to reposition the camera, the surgeon simply moves his/her hands.” Ironically, the system is called “da Vinci” in part because Leonardo da Vinci invented the first robot. He also used unparalleled anatomical accuracy and three-dimensional details to bring his masterpieces to life. The da Vinci S Surgical System similarly provides physicians with such enhanced detail and precision that the System can simulate an open surgical environment, allowing operation through tiny incisions. Robert Graebe, M.D., chairman of obstetrics and gynecology at Monmouth Medical Center, explained the benefits of using the robot. “Adoption of laparoscopic techniques, for the most part, has been limited to routine procedures. Robotics now enables surgeons to take a minimally invasive approach to surgery for more complex cases where open surgery was considered the standard protocol. As a result, there are typically shorter recovery times, less pain, less blood loss, fewer transfusions, fewer infections and reduced hospitalization costs.” Dr. Graebe added that the major benefits of using the robotic system for surgeons over traditional approaches are greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access. It cannot be programmed, nor can it make decisions on its own to move the surgical instruments. Robotic surgery may improve surgical outcomes and patient safety. For example, the robotic system has already transformed the field of prostate surgery. Robotic surgery enables the surgeon to perform a wide array of urologic procedures, most specifically a prostatectomy, with a minimally invasive approach (through 1-2 cm incisions), when conventional open surgery is the standard. A surgeon can remove the walnut-size prostate and lymph nodes, and reattach the bladder to the urethra without once putting his/her hands inside the patient. Three robotic arms that are used in the incisions hold a camera and surgical instruments that are able to dissect and suture the tissue of the prostate. Unlike conventional “open” surgery, these instruments are not directly touched by the surgeon’s hands. He or she looks into a viewfinder to examine 3-D images being sent by the camera inside the patient. Joystick controls, located just under the screen, are used by the surgeon to manipulate the surgical instruments. The system is so sophisticated that the joysticks and the surgical instruments move in sync with the precise movements of the surgeon’s hands. According to a recent study, robotic prostatectomy surgery patients had a 14 percent higher rate of cancer removal and, on average, regained urinary function in about a month and a half—four times as fast as open-surgery patients. Also, robotic patients experienced an increase in nerve sparing, which resulted in a lower incidence of sexual dysfunction – while half of the open-surgery patients experienced a higher rate of impotence two years later. Currently there are more than 300 da Vinci Surgical Systems in use worldwide. Monmouth Medical Center’s affiliate hospital, Newark Beth Israel Medical Center is the northeast training center, which means surgeons throughout the Northeast come to Newark Beth to train and learn how to use the da Vinci robot. Monmouth Medical Center will be a regional robotic surgical center, enabling those surgeons from area hospitals who meet the criteria, specialize in minimally invasive surgery and are trained in robotics to use the system at Monmouth. Vozos said patients should not assume just because the word “robot” is used to refer to the technology that surgeons aren’t actually performing the procedures. “This system is designed to seamlessly replicate the movement of the surgeon’s hands with the tips of micro-instruments. The system cannot make decisions, nor can it perform any type of movement or maneuver without the surgeon’s direct input. Instead, it helps surgeons enhance their ability to perform complex minimally invasive surgeries.” Robotic surgical procedures are taking place at Monmouth Medical Center. For more information, call 1-888-SBHS-123. [ top ] [ back to 2006 News Index ] |
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