NY Robotic Surgeon Explains Minimally Invasive Surgery with the da Vinci® Robot

Posted on: October 8, 2012

Robot-assisted Surgery Got its Start on the Battlefield

by Dr. Warren Bromberg

The original destination for guided robotic surgery was the battlefield: The hope was that expert surgeons could operate on injured soldiers remotely. While these plans have yet to pan out, robotic technology has been adapted for civilian use.

Northern Westchester Hospital now has two such devices, the da Vinci® Surgical System.  We got our first machine more than five years ago, and it was one of the first in the area. Initially, I and other urologists used robotic surgery primarily for prostate cancer surgery. The small incisions and 3D magnification meant less scarring, better visualization of important nerves, and a quicker recovery. Then we realized that we could do many other types of da Vinci surgery with less trauma for the patients.

With robotic surgery, the surgeon sits at a console not unlike a video game, operating several mechanical arms. Through keyhole incisions, the surgeon is able to direct the use of tiny instruments that can cut, clamp, and suture. A high-definition 3D-camera affords the surgeon an excellent, up-close view of the surgical site. Instruments designed for human hands are much larger than one held by a thin, robotic pincer. What’s more, the robotic movement can be set at a one-to-10 ratio, which means that for every small movement the surgeon makes, the robot moves 10 times more slowly. The combination of small instruments and special advanced imaging techniques allow very accurate surgeries and the ability to preserve more normal tissue.  For example, using the most advanced robotic system, now available at Northern Westchester Hospital, a special mapping technique allows the safe removal of a kidney tumor while blood continues to flow through the majority of the kidney.

The advantages are so appealing that surgeons from other disciplines—colorectal, gynecological and general surgery—are using the devices.

Editor’s note:  Warren Bromberg, MD is Chief of Urology, Director of Prostate Cancer Program and Co-Director of Northern Westchester Hospital’s Institute for Robotic and Minimally Invasive Surgery (IRMIS).

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