By Robert Kimmel
The most advanced minimally invasive surgical system is now available at Phelps Hospital. Recently acquired for use in the hospital’s Surgi-Center, the da Vinci Xi Surgical System is a robotic, computerized mechanism that offers major advances over more conventional surgical techniques. Its first use at Phelps is scheduled this month.
Controlled by a surgeon sitting at a computer console near the operating table, up to four very thin robotic arms, with surgical instruments and with a light and camera, an endoscope, attached to one of them, are able to enter the patient’s body through small incisions to perform the operation. As the surgeon peers into the console, and manipulates the arms remotely, he/she is able to observe a high-definition, magnified, 3-D view of his work.
The initial operation at Phelps will be performed by Dr. Darren Rohan, who is regional director of Northwell Health Physician Partners thoracic surgery program for Westchester. He leads the robotic-assisted thoracic surgery team at Phelps.
“Before the robot, it was like using small instruments on the end of long sticks, and you were able to do things, but you were limited.”
—Dr. Darren Rohan
Dr. Rohan, who has performed robotic surgery for almost five years, and who has specialized in standard minimal invasive surgery, which is also performed through tiny incisions, described the difference. “Before the robot, it was like using small instruments on the end of long sticks, and you were able to do things, but you were limited,” he explained. “But with the robot, it is like minimizing your hands and having them in the body, doing what you have to do, because they have a greater degree of freedom than your hand or wrist would have. I feel like my hands are in there, but I am sitting next to the patient controlling the robot.”
The da Vinci instruments inside the body have joints, which can bend in different directions, can grasp, cut and halt bleeding by cauterizing. They are controlled by the surgeon’s hand movements on handles at the console. The da Vinci system, which costs about $1.5 million, is being widely adopted by hospitals in the United States. It can be used for a variety of operations including gynecological, urological, thoracic, cardiac and general surgical procedures. It is credited with being able to perform procedures that would otherwise be impossible or more challenging to do, and it results in less pain, and less bleeding, leaves much smaller scars and requires a shorter recovery time, among other advantages.
“Phelps is very much committed to getting the latest of technologies, and has the financial backing of an entire health system, Northwell, behind it,” explained Dr. Richard Peress, Director of the Department of Surgery. In January 2015, Phelps became part of Northwell Health, which has 21 hospitals and more than 550 outpatient clinics, making it the state’s largest health care provider. Dr. Peress stated that Phelps was intent on “getting the doctors who work best with that technology and provide the highest level of services, university level of services, at a very friendly community setting.”
Dr. Avraham Merav, Chief of Thoracic Surgery, noted that Phelps had begun early on “using minimum invasive surgery techniques, and developed a very robust program for chest surgery,” adding that, “We are very happy now to improve on that with the robotic system.”
The first da Vinci system was approved by the Food and Drug Adminstration in 2000, and worldwide millions of operations have been performed using it. The Xi is the latest state-of-the art version made by the American company, Intuitive Surgical. The use of the da Vinci system at Phelps will not result in additional costs for patients who undergo surgery with it according to Dr. Peress, who sees it as part of the continuing evolution of medical science.