NEWARK, N.J., Feb. 1, 2003 -- In
the winter of 2003, cardiac surgeons at Newark Beth Israel
Medical Center began performing robotic surgery using the
da Vinci Surgical System developed by Intuitive Surgical
as an alternative for patients requiring certain open-heart
procedures including mitral valve repair. As a minimally
invasive alternative to traditional surgery, robotic surgery
allows patients to spend less time in the hospital, experience
less pain, and recover faster.
Last October, a breakthrough occurred at Children's Hospital
of New Jersey at Newark Beth Israel Medical Center (CHNJ)
when, for the first time in the state, the same da Vinci
robot was used to perform surgery on a pediatric patient.
Jeffrey Stock, MD, pediatric urologist, used the da Vinci
Surgical System to perform pyeloplasty, a procedure to repair
a blockage in the kidney. The patient, a 10-year-old girl,
suffered from a congenital abnormality that causes the ureter
to narrow at the point where it connects with the kidney.
Traditional surgery to repair this condition includes creating
a 4-5" incision below the patient's 12th rib and dividing
muscles to reach the affected area, all of which makes for
a painful experience for the patient, according to Dr. Stock.
"The da Vinci robot allows the surgeon to do the fine work
of eliminating the segment of the ureter that's narrow and
sewing the ends back, all through two small ports. The entire
procedure is less invasive and less painful than traditional
surgery," he said.
The da Vinci System consists of a surgeon's console, a patient-side
cart, a high performance 3-D vision system and EndoWrist
articulating instruments. In the operating room, 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, two robotic arms and one endoscope arm
precisely translate the surgeon's movements through small
puncture incisions, or ports, in the patient. Supporting
surgical team members install the instruments needed for
the procedure being performed and supervise the robotic arms
and tools as they are being used.
Since that first case in October, Dr. Stock has performed
pyeloplasty with the da Vinci robot on four more pediatric
patients, among them 12-year-old Nicholas Santangelo of East
Hanover. Nicholas’s parents, Debbie and Robert, were
referred to Dr. Stock when their son’s condition was
inadvertently discovered after he had oral surgery. “While
Nicholas was in the operating room for the oral surgery he
was hooked up to an IV, so there was a lot of fluid in his
body,” said Robert. “At home the next day, Nicholas
experienced pain in his lower back that gradually became
more intense. It was then that I remembered in the past he
would comment that he felt minor pain in his lower back,
but it always went away quickly.” Nicholas’s
parents brought him to the local emergency room, where doctors
initially suspected the boy had a kidney stone. Further examination
revealed no stone, but the kidney was filled with fluid.
The Santangelos were referred to Dr. Stock, who performed
more tests and discovered that a blood vessel was pressing
hard against Nicholas’s ureter, preventing fluid from
draining from his kidney.
Dr. Stock told the Santangelos about the option of correcting
Nicholas’s condition through minimally invasive surgery
with the da Vinci robot. “Dr. Stock said he wanted
to correct the problem through a new type of procedure so
Nicholas could recover faster. I was a little nervous at
first because I wasn’t familiar with the da Vinci robot,” said
Debbie. “But then I saw the robotic equipment in the
operating room, and the nurses explained to us how the surgeon
sees everything in 3-D. The staff were very warm and knowledgeable,
and very aware of what needed to be done. I walked out of
the OR and told my husband that I felt so much better, very
comfortable and relieved.”
Nicholas’s operation took place on Jan. 29, and the
entire procedure lasted just over two hours. Everything went
smoothly, and he was discharged the following day. Today,
he is back to his studies as a 7th-grade student at East
Hanover Middle School, spending time with his three siblings,
and enjoying his favorite activities. The Santangelos are
relieved to have this experience behind them, and pleased
that minimally invasive surgery with the da Vinci robot was
presented to them as an option. “If Nicholas had undergone
traditional surgery, his pain would have been more intense
and his recuperation longer. I’m so happy that we brought
him here,” Debbie said.
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