Surgery from six feet away: Robot technology becomes OR reality

The quest for less invasive surgery is leading to a new presence and a Renaissance approach in the OR.

By Susan J. Landers, AMNews staff. Feb. 11, 2002.

Falls Church, Va. -- What has three arms, no head and is infiltrating operating rooms around the world? It's a robot designed to perform major surgery through the smallest possible incision.

The robot, a part of the da Vinci Surgical System, looms over a patient undergoing heart surgery at Inova Fairfax Hospital in suburban Washington, D.C., and looks more foe than friend.

But rather than warding off an attack, the surgical team is welcoming this newcomer, using words like "fascinating" and "blows me away," to describe its work.

The robot is the latest technological step in a decade-long move toward less invasive surgery.

Approved by the Food and Drug Administration for thoracic procedures in March 2001, the da Vinci system allows surgeons to perform very delicate and complex surgeries through the most minimal incisions. It also has gained the FDA's nod for use in surgical assistance, general laparoscopic surgery, minimally invasive thoracic surgery and prostate removal.

The robot system has not yet been approved for heart, brain and spinal cord surgery.

"The challenge has been to get the same surgical results through smaller incisions," said Paul Massimiano, MD, a cardiac surgeon at the hospital.

Smaller incisions translate into benefits for a patient: a shorter hospital stay and less risk of infection, he noted.

The system's major advance over its predecessors comes with its ease of use. Unlike many of the laparoscopic instruments, in which down is up and up is down, the robot directly mimics the moves of a surgeon's hands. [...]