Urogynecologic Surgeon Says Robotic
System Is More Precise Than Laparascopic Procedures
When Newark Beth Israel Medical Center surgeon Emad Hashemi
learned how to perform minimally invasive surgery, the laparoscope
was the instrument of choice.
Then robotic surgery came along. And Hashemi, who is chief
of Urogynecology and Pelvic Reconstructive Surgery at Newark
Beth Israel Medical Center, learned how to perform familiar
procedures with different instruments.
He was amazed at what he saw.
“Robotic surgery is just more precise, much more absolute,” Dr.
Hashemi says. “You have much more control with robotic
surgery.”
Dr. Hashemi used the da Vinci® S robotic
system in surgery for the first time in December 2006. He
used it to perform a sacral colpopexy, which is considered
the gold standard for repairing vaginal vault prolapse.
He has performed a handful of sacral colpopexies robotically
since then, making him one of the few doctors in the country
to perform this delicate surgery robotically.
In addition, Dr. Hashemi has used robotics to perform uterosacral
ligament fixation procedures, which is another way of repairing
vaginal vault prolapse; as well as standard hysterectomies.
The Food and Drug Administration granted clearance for use
of the da Vinci® Surgical System for use
in gynecological procedures in April 2005, opening the door
for Dr. Hashemi to use the new technologies in surgery.
More surgeons may follow suit, particularly when you consider
that approximately one in nine women in the United States
will have a hysterectomy in their lifetime, and, of those,
10 percent to 30 percent will develop vaginal vault prolapse,
according to mayoclinic.com.
Meanwhile, vaginal vault prolapse is yet another robotic
surgery performed at Newark Beth Israel, where surgeons currently
perform robotic surgery in more specialties than any other
facility in the nation. The hospital is a member of the Saint
Barnabas Health Care System.
Additionally, Dr. Hashemi was able to be an early adapter
on using the new technology because Newark Beth Israel is
home to a recently-opened Robotic Training Center, where
surgeons from around the world learn advanced robotic surgery
techniques using the da Vinci® S Surgical
System.
The Robotic Training Center has trained more than 100 surgeons
on the da Vinci ® S since opening last
year. The doctors have come to Newark Beth Israel from throughout
the country, including from hospitals such as Yale-New Haven
Hospital, Evanston Northwestern Healthcare, Massachusetts
General Hospital and the Mayo Clinic.
Dr. Hashemi believes that performing robotic surgery feels
like writing with a pencil the conventional way. By comparison,
the laparoscopic version offers less control to the surgeon – a
lot like trying to write with pencil by gripping the eraser
end.
“I have much more control of the instruments (with
robotics) in 360 degree rotation and ‘XYZ’ directional
movement to make tissue dissection and suturing with more
precision,” says Hashemi. “I make small incisions,
which means there is less risk of distortion of normal anatomy,
less bleeding, infection and pain.”
A native of Iran who holds a medical degree from Saint George's
University School of Medicine in Grenada, West Indies, Dr.
Hashemi completed his residency in OB/GYN at Newark Beth
Israel, where he served as Chief Resident of OB/GYN. Following
that, he did a fellowship in urogynecology at Athena
Women’s Medical Center, a teaching affiliate of the
University of Medicine and Dentistry of NJ (UMDNJ), in Turnersville,
N.J. before returning to Newark Beth Israel to become chief
of Urogynecology and Pelvic Reconstructive Surgery.
Dr. Hashemi also says robotic surgery provides him with
a three-dimensional visual field of the region that he is
operating on. With robotic surgery, the surgeon sits at the
console with his hands on the master controls and his eyes
on a 3-D image of the surgical field.
From the patient-side cart, four robotic arms and one endoscope
arm precisely translate the surgeon’s movements through
small incisions in the patient.
In the future, Dr. Hashemi believes that more and more surgeons
will follow suit and using robotics where they now use the
laparoscope.
“As time goes on, a larger number of surgeons will
become comfortable with this machinery and turn to robotics,” he
says. “We will see how far we can go with robotics.”
Publication: Hospital Newspaper
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