By SHANKAR P.
NEWARK -- Users of YouTube,
the “broadcast yourself” Web site, can call up
videos of robots performing surgery at the Newark Beth Israel
Medical Center of the Saint Barnabas Health Care System. “It’s
so cool!” says a viewer comment about one of the six
videos. (Readers can watch for themselves by logging on to
youtube.com and typing “savatta” in the search
field.)
“Robotic surgery is becoming mainstream at our hospital,” says
Dr. Dennis Bordan, chairman of the department of surgery
at Newark Beth, or The Beth, as the 106-year-old hospital
is known in the health care community.
“Patients increasingly demand it, and the results warrant
it,” Bordan says of robotic surgery, which the Food
and Drug Administration (FDA) approved seven years ago. “Over
the next five years it will become mainstream throughout
the country,” he says.
In robotic surgery, surgeons use foot pedals and hand grips
to guide the robot’s arms, calibrating their moves
with the aid of magnified 3-D images on video consoles. The
procedure is most commonly used in prostrate cancer, urology,
oncology and adult cardiac surgery.
Bordan says robotic surgery is more precise than standard
methods and requires minimal incisions, resulting in less
blood loss, pain and scarring and faster recoveries. Insurers
can benefit as well, he says, since patients spend fewer
days in the hospital.
Dr. Stanley Harris, senior medical director at insurer Horizon
Blue Cross Blue Shield of New Jersey, calls it too early
to identify the gains from his company’s standpoint.
However, he says, “we can expect to see savings in
hospitalization costs” with shorter recovery times
and reduced blood loss.
Harris says robotic surgery may face limitations in certain
situations, such as for patients who have had extensive previous
surgery or require extensive abdominal surgery. “But
[robotic surgery] has amazingly wonderful precision and,
in the right hands, can have significant advantages over
traditional surgical procedures,” he says.
Bordan says New Jersey hospitals currently have a total of
20 to 25 surgical robots, with the da Vinci system from Intuitive
Surgical of Sunnyvale, Calif., the most popular. Facilities
with surgical robots include Robert Wood Johnson University
Hospital, Hackensack University Medical Center, Morristown
Memorial Hospital and Saint Clare’s Hospital in Denville.
The Beth has three da Vinci surgical systems and has conducted
1,274 robotic procedures in the past four years. The hospital
claims to have the largest robotic training program in the
Northeast and says surgeons from around the world make use
of it.
The Beth was two years into its robotic surgery program when
Bordan arrived in 2005 and spotted a business niche that
could grow. “The bets have paid off,” he says.
“We are the busiest in New Jersey, and have become
the center of local, regional and national prominence in
robotic surgery.”
A robotic surgery program could prove challenging for some
hospitals, given the capital cost. A typical robotic surgical
system costs about $1.5 million, which The Beth amortizes
over five years. Bordan says the hospital must do at least
20 robotic surgeries a month to meet the required payments.
That’s no problem for The Beth, he says, which currently
does 20 to 25 such surgeries a week. Dr. Domenico Savatta,
chief of adult urologic robotic surgery at the hospital,
says he personally does about 25 of the procedures a month.
“Once somebody is experienced with the system, they
can do better surgery than what is possible with their hands,” says
Savatta. “The images are magnified, and the robot’s
arms move like your hands, but with more rotations and extensions,
and are much more flexible than your wrists.”
Savatta says robotic surgery allows him to do things that
would not have been otherwise possible. He says he recently
made a new bladder from an intestine during surgery on a
patient with bladder cancer.
He acknowledges that some patients have concerns about how
much they can trust a machine. A common question, he says,
is, “What happens if the machine breaks down during
an operation?”
He says the robots have failed twice during his surgeries,
once during a kidney operation and again in a procedure involving
prostate cancer. He finished one of the operations with a
spare robot and switched to conventional instruments for
the other.
Harris says robotic surgery may face limitations in certain
situations such as for patients with extensive previous surgery
or extensive abdominal surgery. “But it has amazingly
wonderful precision, and in the right hands, it can have
significant advantages over traditional surgical procedures.”
Publication: NJBIZ
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