A box resembling an arcade game with hand controls and pedals is
now the new knife and scalpel surgeons have traditionally used for
centuries.
Robotic surgery is becoming increasingly popular as one of the
minimally invasive techniques used by surgeons across the country,
as well as many UCLA urologists, cardiothoracic surgeons,
gynecological surgeons and general surgeons.
The massive size of a surgical robot attached to a control booth
in an operating room can appear deceptively large, but three probes
with approximately nickel-sized diameters attached to the robot are
making surgery easier, more efficient and less painful.
The widely applicable technology is being used in many
operations, from cardiothoracic bypass operations to the removal of
prostate and cervical cancer.
Computer-assisted technology enables surgeons to operate small
robotic instruments to perform more precise movements, allow a
better range of motion, and provide amplified video-images in a
three-dimensional format.
“Robotics has revolutionized surgical care and treatment
by reducing incisions, decreasing the need for pain medication, and
shortening recovery times and hospital stays,” said Dr. Ramin
Beygui, a cardiothoracic surgeon who has used the technology in his
operations.
The robot’s instruments can mimic the complex movements of
the hand, sense adjustable levels of tissue resistance through
detectors, and minimize the amount of space involved in
conventional surgery. Cameras are also attached to the probes so
that large incisions are no longer necessary, he said.
One of the first five patients who underwent a robotically
assisted hysterectomy at UCLA, Deanne Ring, a resident of Port
Hueneme, said she was reassured by the confidence of her surgeon
Dr. Jeannine Rahimian.
“Instead of being in the hospital for five days, I was
able to eat dinner at home the next night,” said Ring. Only
two days after the surgery, she was able to drive her car.
Dr. Robin Farias-Eisner, a UCLA professor and chief of the
gynecology and gynecologic oncology departments at the UCLA Medical
Center, was the first surgeon in California to use robotics in
hysterectomies. He has used robotics in around a dozen operations
since the Food and Drug Administration approved the technology last
spring.
“Robotics reduce recovery time, and that is important in
making hospital beds available for other patients,” he
said.
Robotics technology has future potential in other fields,
including use in neurological surgery and fetal surgery.
The minimally invasive technology could remove tumors with
minimal incisions through healthy brain tissue, thereby reducing
trauma. The aid of magnifying cameras can also improve accuracy and
efficiency, said Dr. Beygui.
The development of this technology could allow surgeons to
perform operations that are currently inaccessible to surgeons such
as fetal operations. With smaller equipment and better
magnification, one could correct defects in a fetus while it is
developing in the uterus, said Dr. Farias-Eisner.
Some children are born with defects in the diaphragm or with
immature lungs, and robots may enable the surgeon to access the
fetus and operate on such a tiny scale and make corrections, added
Dr. Beygui.
Robotics have been used in operating rooms at UCLA since 2000,
said Dr. Peter G. Schulam, a urological surgeon and associate
professor at UCLA who applies robotics in prostate cancer
patients.
Expert surgeons may also soon be able to operate on patients
from miles away, watching a magnified monitor while surgeons
trained in the technology are beside the patient, he said.
There is currently a study funded by the government, UCLA and
other hospitals aimed at developing and testing the possibility of
a telesurgical network where expertise can be provided across long
distances using robotics and the Internet.
Licensure and liability are the major issues being addressed,
said Dr. Schulam.
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