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Robot Bridges Gap in Colon Surgery

Posted on: Friday, 14 April 2006, 06:00 CDT

By Jamie Talan

This was an operation in which the surgeon never touched the patient.

Patricia Watkins, 55, of Central Islip suffered bouts of severe abdominal pain from diverticulitis and needed to have part of her colon removed, an operation that normally is done using the tiny snake-like laparascope.

But Dr. George DeNoto, chief of laparoscopic surgery at North Shore University Hospital in Manhasset, figured out a way to perform the operation using a robot - a feat never successfully done by any other surgeon.

The robot, unlike the laparoscope, gives a three-dimensional view of the colon. But the narrow area in which the robot is able to maneuver had made it impossible - until DeNoto's innovation - to use on a large area, like a diseased colon.

DeNoto expanded the robot's surgical coverage with a two-step approach: first, he sets up the robot to work on one area of the abdomen. After surgery is completed on that area, the robot is then briefly disconnected while the patient is repositioned. The 1,300-pound robot, often used in heart, urological and gynecological operations, is moved and reconnected to the patient. Then the second part of the surgery is completed.

"It gives us a new tool to help people undergoing surgery for colon diseases such as diverticulitis," said DeNoto, who said that the repositioning takes about five minutes.

Diverticulosis, a condition in which small pouches in the colon that bulge in weak spots, is very common as people age. Diverticulitis develops if these weakened pockets become infected, causing swelling and pain. Doctors first try antibiotics to treat it, but repeated bouts may call for surgery.

DeNoto has already done 10 operations using the robot, called da Vinci. He said he will follow the patients to see whether it has more benefits than laparoscopic surgery.

Although minimally invasive laparoscopic surgery has been a boon to surgeons, it takes away a three-dimensional view of an operation. As the tiny tools snake inside small incisions, the scopes offer about 4 degrees of movement - up, down, left, right or a rotation.

By contrast, the robot expands the surgical field to 7 degrees. Da Vinci's robotic arm has miniature cables and pulleys that go deep into the operating field. Like a surgeon's wrists inside a body, the robot can operate around corners, cutting and suturing. During an operation, the surgeon sits at a console, looking down into two scopes, which provide a full, three-dimensional view.

North Shore bought da Vinci, approved by the Food and Drug Administration in 2000, for $1.3 million in 2004. It was the first on Long Island. Earlier this year, St. Francis Heart Center purchased its own surgical robot.

DeNoto said that using the robot for colon surgery "is a benefit to surgeons. What we don't know yet is whether it will benefit the patients."

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Copyright (c) 2006, Newsday, Melville, N.Y.

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