Cache Valley Hospital has upgraded its surgical robot, and this week it invited locals to come test out the tech.
The hospital has had a da Vinci Si surgical robot for a few years, according to surgeon Mark Hansen, but the hospital’s new Xi model is “just literally years ahead of the Si.”
The robot assists in laparoscopic surgery, where instead of making large incisions to access tissues and organs (open surgery), surgeons make only small cuts and insert a tool with a small camera (called a laparoscope). While the surgical instruments typically used in laparoscopic surgery are straight, the da Vinci robot’s tools can bend and rotate like a hand on a wrist.
“Regular laparoscopic instruments are just straight tools,” Hansen said. “They’re straight sticks where they can turn them side to side and that’s about it.”
It’s a lot easier to do things like sutures with a tool that can bend at the wrist, Hansen said.
“The instrumentation is such that we can do a lot more sewing, dissecting, visualizing,” Hansen said. “We can do that better with the robot than we can just laparoscopically. So in cases where there’s a lot of sewing that has to happen within the abdomen, those are much easier to do with the robot than they are with the standard laparoscopy.”
Da Vinci’s manufacturer Intuitive brought its mobile demonstration unit to the hospital’s lobby this week, letting visiting kids, seniors and everyone in between try it out.
The mobile unit includes two consoles just like the one Cache Valley Hospital surgeons use. One is connected to a simulator, which runs virtual reality simulations for surgeons to learn to use the instrument on. The other console is connected to an actual robot the company uses for demonstrations. An attendant walked participants through various challenges, such as manipulating a $5 bill, doing mock-sutures or unwrapping pieces of Starburst candy.
Each console has eyepieces that let the operator see through the 3D camera on the robot’s laparoscope. Operators put their fingers through small fabric loops attached to articulated, motorized controls that replicate the surgeon’s movements with the robot’s instruments.
The robot itself consists of a tall mobile stand with four white arms hanging down. One arm is for the laparoscope and the other three are for instruments. The surgeon can control two of the instruments at a time through the hand controls, and pedals and other controls manipulate the camera or allow the surgeon to switch instruments.
The robot’s 3D, high-def camera is also capable of fluorescence imaging, allowing surgeons to see things they couldn’t see with a typical laparoscope.
“We can inject some fluoroscein-type liquid into the body and then that will allow us to see structures that we really can’t see because they’re behind tissue,” Hansen said. “It lets us see the bile duct, for example, or it lets us see blood vessels, or it lets us see the ureters so we can know where those things are.”
Another big advantage of the system, Hansen said, is it makes some surgeries less physically demanding.
“Even with the robot, the surgeon is doing the surgery,” Hansen said. “But with the robotic surgery, the surgeon is sitting down at a separate console just a few feet away. So on a long, tedious case where normally we would be standing at the bedside, having to reach with our arms to do the instruments, we can literally sit down.”
In Hansen’s experience, the robot is opening up more and more procedures to the possibility of laparoscopy, meaning smaller incisions, less pain and quicker recoveries.
“I think we’re going to be finding more and more uses … for the robot as we go along,” Hansen said. “I’ve started to do gall bladder surgeries robotically because it adds some things.”
Procedures assisted by the robot at Cache Valley Hospital include several gynecologic surgeries, including hysterectomies, endometriosis resection and others, as well as general surgeries such as hernia repairs and colon surgery.