In Brief

• The Center for Minimally Invasive Surgery at Springfield Hospital has recently purchased the da Vinci Surgical System, an FDA-approved robot that is designed to provide surgeons with the potential to convert many complex surgical procedures to minimally invasive surgeries.
• Crozer-Keystone surgeons have gone through specialized training to learn how to use the device and are now using the system in the treatment for prostate cancer, pelvic floor disorders, fibroid tumors and fallopian tube reanastamosis. 
• The da Vinci system features a special console that has hand and foot controls to move the robotic arms. A tiny 3-D camera is used to help the surgeon see as he performs intricate surgical procedures.

Prostatectomy is performed using the da Vinci Surgical System at the Center for Minimally Invasive Surgery at Springfield Hospital.

Robotic surgery is no longer the basis of science fiction, but rather the latest technology available to patients at the Center for Minimally Invasive Surgery at Springfield Hospital. The hospital recently purchased the da Vinci Surgical System, an FDA-approved robot that is designed to provide surgeons with the potential to convert many complex surgical procedures to minimally invasive surgeries.

Crozer-Keystone surgeons have gone through specialized training to learn how to use the device and are now using the da Vinci Surgical System across a wide array of surgical procedures such as the treatment for prostate cancer, pelvic floor disorders, fibroid tumors and fallopian tube reanastamosis. 

The da Vinci system features a special console that has hand and foot controls to move the robotic arms.

A tiny 3-D camera is used to help the surgeon see as he performs intricate surgical procedures.

The da Vinci translates the surgeons’ natural hand motions at the control console into corresponding movements of the robotic instruments.

Prostate Cancer

Closely surrounded by many structures and nerves, and encasing the urethra, the prostate gland is located below the bladder and in front of the rectum — in an area both sensitive and difficult to access. This is unfortunate considering cancer of the prostate gland is the leading cancer among men and the second leading cause of death in American men.

In the early stages, prostate cancer treatment options may include radical prostatectomy, radiation and/or watchful waiting. Now, using the latest technology in robotics and computer technology, Crozer-Keystone urologists can offer patients the effective option of robotic-assisted prostatectomies, making it an alternative for patients whose cancer is confined to the prostate and are otherwise in good health.

According to James O’Connell, M.D., chief of the Section of Genito-Urinary Surgery at Delaware County Memorial Hospital, prostate surgery has changed dramatically over the years. “First there was traditional open radical prostatectomies­, requiring an 8-10 inch incision and resulting in blood loss and uncomfortable recovery. Then came conventional laparoscopy, which is minimally invasive, but requires the surgeon to look up and away from the instruments to a nearby two-dimensional video monitor to see an image of the anatomy. Now, the robot is revolutionizing the procedure with its three-dimensional images, brilliant color and natural depth of field.”

For patients, these benefits include less post-operative pain, less risk of infection, less blood loss, shorter hospital stays and faster recovery.

“What is done during surgery has not changed,” says Kenneth Weisman, M.D., chief of the Section of Urology at Taylor Hospital. “However, the tools we use during the procedure are drastically changing and improving, giving us the opportunity to turn what was once a radical procedure into a minimally invasive one.”

“I think offering the da Vinci to Crozer-Keystone patients will only further advance urologic care now and in the future,” says Frank D’Elia, M.D., chief of the Division of Urology and Urologic Oncology at Crozer-Chester Medical Center. “Robot-assisted surgery will be around for many years to come and the application of it will only increase with time. It is exciting to be using this new technology.”

Urogynecology

Pelvic floor disorders, including vaginal prolapse and urinary incontinence, affect close to 50 percent of women at some point in their lifetimes. For those women who experience pelvic organ prolapse, surgery may be required to treat their condition.

In 2005, the U.S. Food and Drug Administration approved the da Vinci for gynecological surgery. Jose Maceda, M.D., chief of the Division of Female Pelvic Medicine and Reconstructive Surgery at Crozer-Chester Medical Center, is a fellowship-trained urogynecologist who is offering this state-of-the-art treatment to women with pelvic organ prolapse.

“I’m confident that by offering this technology to patients, we can significantly improve the quality of life for many women,” Maceda says. “We will obtain the same results of open surgery, while having smaller incisions and a shorter recovery time”

Reproductive Endocrinology 

Nearly 180,000 women each year in the United States who have fibroid tumors make the decision to have a hysterectomy, causing them to lose their fertility. Now, Crozer-Keystone patients have the option of a robotic-assisted myomectomy that is performed with the da Vinci.

The da Vinci gives the surgeon the tools needed for precise three-layer suture reconstruction of the uterus, enhances the capabilities for meticulous dissection and enucleation of large myomas, and provides superior visualization of tissue planes.

Albert El-Roeiy, M.D., chief of the Division of Reproductive Endocrinology and medical director of the Fertility Center at Crozer, has been trained to perform robotic myomectomies as well as fallopian tube reanastamosis.

“The da Vinci provides the tools needed for the precise reconstruction of the uterus during a myomectomy,” El-Roeiy says. “But most importantly, a robotic myomectomy allows women to maintain their fertility while surgically removing their fibroid tumors.”

For women seeking to reverse their tubal ligation, the da Vinci technology enhances El-Roeiy’s ability to perform the fine suturing required to reattach the two ends of the fallopian tube. The more accurate and delicate the suturing can be, the less scar tissue will form at the reattachment site.

Although not all patients are candidates for surgery with the da Vinci Surgical System, Crozer-Keystone surgeons are trained in open and laparoscopic surgery and will meet with patients to determine which surgical option is best.