Robotic Surgery Offers Precise Handling, Quicker Procedures

May 5, 2009 — -- A small but growing number of patients are getting a new option in the operating room -- robots that are helping surgeons perform more complex procedures.

When 54-year-old Bill Souter was diagnosed with cancer last month and told his prostate would need to be removed, he was offered the chance to make medical history at the Cleveland Clinic by becoming the ninth person in the world to have his prostate removed through a tiny incision in his belly button.

"I feel like I'm pretty important to my family and my friends," he said. " And I don't want to lose that right now. So I feel this is the way to go."

The new technology, called the daVinci Si HD Surgical System, takes the notion of minimally invasive surgery to an entirely new level.

Because a person's naval is just skin and abdominal lining, doctors don't have to cut through layers of muscle.

"If we can avoid cutting through muscle, we can minimize the pain of the patient," the Cleveland Clinic's Dr. Jihad Kaouk said.

And the new technology is not just for prostates. It can be used for appendixes, hysterectomies, even to take out parts of the liver, and lymph nodes, all through the belly button. And the robot can even seal the organ in a plastic bag before it's removed from the body.

"It's quite a medical feat, I would say," Souter said.

And another breakthrough in the past month included the addition of a new surgical arm with life-like finger controls so precise that the robot can tie tiny knots in the sutures.

"I think we're at the tip of the iceberg; I think the technology we have now is unbelievable," said Dr. Michael D. Stifelman, director of robotic surgery at NYC Langone Medical Center.

That technology also includes robot eyes -- miniature cameras that now come in high definition, magnified 10 times so doctors can see images inside the body so intensely it's like seeing at 20 feet what others can see only at 10 feet.

At NYU, Stifelman can now see and remove a tiny kidney tumor the size of a pencil eraser while leaving most of the kidney intact.

"The possibilities are endless," he said. "It's just what we can create to make this better."

The new technology enables doctors to perform more complex procedures while minimizing blood loss and the time a patient needs to stay in the hospital.

There are more than 1,000 daVinci Systems in use at 930 hospitals worldwide and 825 in the United States, according to the manufacturer.

Among the other benefits is that it reduces surgery time. A routine hysterectomy, for instance, takes 92.4 minutes laparoscopically; it takes 78.7 minutes with the daVinci, according to the manufacturer. New ways of using the daVinci surgical system also include urinary reconstructive surgeries and thoracic surgeries.

Stifelman demonstrated for "Good Morning America" how precise the device can be. It can thread a needle, tie a knot and even peel a grape.

The first procedure was done in 2005. Stifelman did one of the first comparative studies of the daVinci in partial nephrectomies and found patients who had the robotic surgery did better and had a quicker recover time than those who had open-incision operations, or laparoscopic techniques.

Stifelman said that even if the operator's hands shake, the instrument definitely won't. The breakthrough is that it eliminates tremors of the hands, he said.

Click here to find out more about robot-assisted urologic procedures.

Click here to find out about radical prostatectomy.