With the assistance of a surgical robot, Pitt faculty members who are surgeons at the University of Pittsburgh Medical Center (UPMC) are now treating early-stage prostate cancer and repairing mitral valves through more precise and minimally invasive surgical procedures that may result in less pain and quicker recoveries for patients.
The da Vinci® Surgical System provides surgeons with a new surgical tool that incorporates the latest technological advances in robotics and computer technology. It extends the surgeon’s capabilities by providing enhanced 3-D visualization and instinctive operative controls, and allows access to the surgical site through small instrument “ports” that eliminate the need for large incisions.
The surgeon views the 3-D image of the surgical field on a television monitor while seated at a console and operates on a virtual field using master controls. The surgeon’s hand, wrist, and finger movements are seamlessly translated into precise, scaled, real-time movements of surgical micro-instruments inside the patient. These features give the surgeon superior access to the operating field while improving dexterity and surgical precision, and in some cases, allowing surgeons to laparoscopically perform procedures that previously had to be done through open surgery.
“By enhancing surgical capability through improved technology, we are able to provide patients with better clinical outcomes so they can return to active, productive lives as quickly as possible,” said Stephen Jackman, associate professor of urology in Pitt’s School of Medicine, who uses da Vinci to perform radical prostatectomies. “Patients who have undergone robotic surgery are reporting high satisfaction with this procedure.”
Traditional radical prostatectomy surgery for prostate cancer is routinely done through a five- to seven-inch incision in the abdomen. With the da Vinci System, the surgery involves only five or six small incisions.
“An estimated 16 percent of American men will be diagnosed with prostate cancer at some point in their lives. For many of these men, the surgical removal of the prostate is the best treatment option, but many are apprehensive about having this surgery,” said Timothy Averch, assistant professor of urology in the Pitt medical school. “Having a prostatectomy using the da Vinci system should ease a number of their fears. By doing the procedure with this technology we are, in many cases, able to reduce the length of hospital stay, risk for infection, blood loss, and recovery time while potentially preserving function.”
In addition to prostatectomies, UPMC surgeons will use da Vinci for cardiac procedures, including mitral valve repair.
“We are excited about using da Vinci for cardiac procedures because the technology offers the promise of being able to do complex cardiac procedures through very small incisions, which is a great benefit for our patients,” said Lawrence M. Wei, clinical associate professor of medicine in Pitt’s medical school.
With the da Vinci system, Pitt faculty members who are surgeons at UPMC can now perform, in a minimally invasive way, major cardiac reconstructive procedures that until now they have been incapable of attempting—most relevant of which is mitral valve repair, according to Daniel Pellegrini, clinical assistant professor of surgery in Pitt’s medical school.
“The primary reasons for this is the binocular vision that da Vinci provides, thus giving us true 3-D vision and depth of field. In addition, the instruments are outfitted with micro wrists that actually have more degrees of freedom than a human hand. These small instruments will allow us to get into tiny areas and enable us to sew or reconstruct areas that traditionally have very difficult angles to access,” he said.
The da Vinci also can be used for the following procedures: nissen fundoplication for the treatment of GERD disease, gastric bypass surgery for obesity, esophageal surgery, thymectomy for Myasthenia gravis, repair of ureter obstruction, and inserting epicardial pacemaker leads for biventricular resynchronization.
