Sutter Santa Rosa Hospital adds to robotic surgery options with new $2 million system

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Dr. Allen Cortez sat at a surgeon’s console that looked a little like an undecorated prototype for a 3-D video game. His hands, tucked inside the pod-like console, controlled two joysticks, while his feet worked foot pedals. A few feet away, robotic arms, wrapped in sterile plastic, hovered above a patient undergoing an inguinal hernia repair in the surgery department at Sutter Santa Rosa Regional Hospital.

The scene, increasingly prevalent in operating rooms across the nation, neatly captured the future of robots in American medicine, and especially in surgery.

Though an eight-millimeter incision in the belly, the robot’s two tiny “wrists,” guided by a 3-D camera, operated deep inside the patient, cutting fat, moving tissue, applying surgical mesh and ultimately closing the wound with sutures.

Cortez, a Sutter-affiliated physician, controlled the operation from the console without ever touching the patient’s innards.

“It’s almost like I’m down there working on something,” said Cortez, co-chair of the robotic surgery program at Sutter Santa Rosa Regional Hospital.

The $2 million daVinci Robotic Surgery system is the latest addition to the new hospital’s robotic surgery program. Its aim is to perform more-precise and less-invasive surgeries that result in less pain, fewer complications, smaller scars and faster recovery times.

Along with a separate orthopedic surgery system launched at Sutter earlier this year, the daVinci robotic device both utilizes and advances computer and automated technology employed by local surgeons, said Mike Purvis, the hospital’s chief administrative officer.

“With these new technologies, we’re moving into arena where the digital revolution can continue to advance our excellence,” Purvis said.

Robotics and computers are increasingly being used in U.S. operating rooms to aid a surgeon’s eyes and hands, easing access into parts of the body that normally couldn’t be opened up without a bigger incision. In the hernia operation conducted by Cortez, for example, the daVinci robotic surgical system eliminated the need to cut through muscle tissue, reducing the amount of pain the patient will later endure after the operation.

Also, the daVinci system limits the exposure of the patient’s surgical area, leading to fewer complications and faster recoveries.

Cortez said that in open surgery, recovery from a hernia repair surgery can take two to four weeks. Robotic surgery cuts that recovery time in half, he said. The daVinci system can be used for a number of surgeries, including gynecologic, urologic, gastrointestinal and general surgery procedures.

The new Sutter equipment builds on previous advancements in instrument-aided operations.

Laparoscopic, or minimally invasive surgery, which became more widely used in the early 1990s, typically incorporates 2-D visualization at about five times magnification over the human eye.

The daVinci features a 3-D high-definition vision system with magnification of 10 times. The robotic hands, tipped with tiny forceps, also have more flexibility than the previous daVinci system, hospital officials said.

“It actually has more dexterity than the human wrist,” Cortez said.

St. Joseph Health plans to launch its own robotic surgery program at Santa Rosa Memorial Hospital. St. Joseph spokeswoman Vanessa DeGier said plans are in place to get a daVinci Single-Site surgical robot that allows surgeons to operate through a small incision in the patient’s belly button.

The device will be used primarily for gastrointestinal, gynecologic and urologic surgeries, DeGier said. St. Joseph has one at Queen of the Valley Medical Center in Napa, where it also is used for cardiac surgeries.

In February, Sutter also launched what it boasts is the county’s only robotics program for orthopedics, with the MAKOplasty surgery system. The new device, which will be used for patients who suffer from joint degeneration caused by osteoarthritis, uses 3-D computer modeling to perform complete virtual surgeries and to test their success before a scalpel ever touches human flesh.

Dr. Briant Smith, medical director of Sutter’s orthopedic surgery program, said that unlike the hospital’s new daVinci robot, the MAKO robot does not move on its own. Instead the robotic arm, which uses a burring tool to grind away bone tissue, is directly manipulated by the surgeon. Still, the robotic arm uses preprogrammed surgical modeling to keep the surgeon from grinding too much bone tissue. When the surgeon reaches the boundaries of the bone area to be removed, the arm resists going any further.

“It allows us to be extremely precise about resection,” said Smith, referring to the removal of tissue or bone. “In a virtual world, we can place the implant on a virtual knee and then plan how the ligaments are going to respond to that placement. …We can basically do the surgery before we actually do anything to the bones.”

The MAKO surgery system cost Sutter about $1 million, Smith said, but its benefits are felt by the patient. A more precise orthopedic surgery such as a knee implant, he said, simply feels “more natural.”

“That’s the key to the operation, having the ligaments be balanced and feel natural when patients are doing things,” he said.

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.

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