June 14, 2008
Allegheny General Hospital Unveils Surgical Robot
By Allison M. Heinrichs, The Pittsburgh Tribune-Review
Jun. 14--When Dr. Don L. Fisher graduated from medical school in 1943, the world was experiencing an explosion in medical advances brought by World War II. Blood transfusions were refined, penicillin was saving lives and the tetanus shot was going mainstream.
"I can think of so many uses for this," said Fisher, 89, after he used his fingertips to command the robot to precisely maneuver tiny surgical instruments. "For minimally invasive surgery, there are great advantages. With no massive tissue recovery, you could send patients home in a day."
Allegheny General Hospital held an open house to show off its $1.5 million da Vinci Surgical Robot. For the past two months, surgeons at the North Side hospital have been using it to treat prostate cancer and gynecological conditions for which incisions would only be about a centimeter. They're considering it for cardiac surgery.
West Penn Hospital in Bloomfield, UPMC Shadyside, the Veterans Affairs Hospital in Oakland and about 700 hospitals nationwide also have the robotic system, said Craig Nicholson, clinical sales representative for Intuitive Surgical in Sunnyvale, Calif., which markets the da Vinci. The company named the device after Renaissance artist Leonardo da Vinci because he is credited by some with creating the first robot.
UPMC has used it since 2004 for cardiac, gynecological, prostate, plastic, gastric bypass and gastroesophageal reflux disease surgeries.
"They're certainly growing in popularity and there have been a lot of patient benefits documented in the medical literature," said Sally Garneski, spokeswoman for the American College of Surgeons.
The robot is about the size of a large man hunched over a surgical table. Four arms hover over the patient like a giant spider, each ending in an interchangeable surgical tool, such as miniature forceps or scissors.
Several feet away, the surgeon sits at a console with a screen projecting a three-dimensional image of the surgical site. The surgeon's index finger and thumb rest in small velcro loops. By pinching and twisting his fingers, the surgeon controls where and how the robot moves its arms. Foot pedals control magnification.
"The first time I sat down at the console, I came home to my wife and said, 'This is the next phase in surgery,' " said Dr. Eugene Scioscia, chairman of obstetrics and gynecology at Allegheny General. "In a few years, residents are going to say to me, 'Dr. Scioscia, how did you operate without this?' "
Scioscia said the robot eliminates tremors from a surgeon's hand, which could be disastrous if a vital organ or cancerous tumor were nicked. It also reduces fatigue because the surgeon doesn't have to hold his arms up and steady for the long time required in many operations, he said.
Eight surgeons in the West Penn Allegheny Health System use the robot.
Dr. Priya Jagga, an obstetrics and gynecology resident at Allegheny General, tried out the robot yesterday.
"It is less complex than I expected," she said. "You still need to be skilled in your procedures, but it gives you so much more precision."
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