Robotic surgery at the forefront of medicine

By Gary Kimsey
Correspondent

When northern Larimer County resident Mike Stanton finished medical school four decades ago, he knew cardiac surgery would be exciting.

Not only would he save lives, but he also envisioned new technology that could benefit patients. Back then, the technology wasn't even available to perform coronary bypasses, catheterizations or other procedures frequently done today.

"It was relatively primitive compared to what we have now," recalled Stanton, a surgeon with the Heart Center of the Rockies, Fort Collins.

The technology did come to pass, of course, but now it's surpassed by newer technology: robotic-assisted surgery.

"Over the years I've been interested in the use of computers and advanced technology in medicine, but there was no way of predicting 40 years ago that we'd be where we are today with robotic-assisted surgery at the forefront of medicine," Stanton said.

Stanton is the only cardiac surgeon using robotic-assisted technology in the region bordered by Omaha, Las Vegas, Phoenix and Canada. The new technology is offered in only 317 of the 6,000 nonmilitary American hospitals.

Stanton uses a $1.2-million da Vinci robotic surgical system that Poudre Valley Hospital purchased in late 2004 from Intuitive Surgical Inc., Sunnyvale, Calif.

The PVH system is used for cardiac, gynecological and prostate surgeries, as well as some types of general surgeries. This makes PVH one of only 20 hospitals in the nation and the only one in the region to offer robotic-assisted surgeries in all of those medical areas.

Various surgeries at PVH are performed by surgeons from the Heart Center of the Rockies, Urology Center, Fort Collins Women's Clinic and Northern Colorado Surgical Associates. The surgeons underwent extensive training on the robotic equipment.

Robotic-assisted surgery is not used on every patient, only ones whose conditions are suited for the technology. The surgery is far different than traditional surgery.

Instead of standing next to an operating table, a surgeon sits at a nearby viewing and control console and peers into binocular-like lenses. His view - a 3-D look magnified 20 times - comes via a tiny specialized camera placed inside the patient. The equipment allows him to change, zoom, rotate, and move his field of vision, giving a more accurate view of arteries, veins, nerves, and other internal areas than traditional surgery.

The surgeon controls robotic arms tipped with tiny endoscopic instruments inserted through small slits into the patient's body. He manipulates the instruments by moving his fingers and thumb together on a small handle. Foot pedals focus the camera or move robotic arms.

All of this results in more precise real-time movements. The equipment never operates on its own. The surgeon is always in control.

Robotic-assisted surgery is less invasive than traditional surgery. Stanton said patient outcomes are better due to fewer medical complications and less pain, bleeding, scarring and risk of infection. The hospital stay is typically shorter - sometimes only a day. Recovery time at home is shorter, usually by weeks.

Stanton uses the robotic system for mitral-valve repairs; closing holes in the heart; removing tumors and masses from around the heart, aorta and esophagus; and performing single-vessel coronary bypass surgery. In the near future, he will perform more complex surgeries, such as aortic valve surgery and two- and three-vessel coronary bypass surgeries.

One of Stanton's Fort Collins patients, John Farrell, describes himself as a walking testimonial for robotic-assisted surgery.

On the day before turning 58 in April, Farrell was at work in his security guard position when he experienced pain in his left arm. He went to PVH's emergency room. Tests showed 90 percent of an artery was dangerously blocked. He was a candidate for bypass surgery.

Farrell was apprehensive.

He remembered two traditional bypass surgeries that his younger brother experienced. The brother's breast bone was cut open - "cracked open," as the procedure is called. His recovery took nearly two months and was extremely painful.

"It knocked him for a loop," Farrell said.

However, Farrell discovered a new playing field exists for bypass patients who undergo robotic-assisted surgery. His breast bone wasn't cracked open. Only two small incisions were made. Time in the hospital: two days. He felt good enough within two weeks that he wanted to return to work.

"I left the hospital and never looked back," Farrell said. "I was virtually pain-free. I flushed my pain medicine down the toilet two days after I returned home. If a person has to have bypass surgery, robotic-assisted surgery is the way to go."

Poudre Park resident Gary Kimsey is public relations and marketing coordinator for Poudre Valley Health System.