Last updated: August 25. 2013 3:02AM - 410 Views

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LIMA — As far as surgeries go, Theresa Nagel was quite pleased with how her abdominal procedure went on Thursday. She also received a dozen red roses, having been the 1,000th patient to undergo robotic surgery at St. Rita’s Medical Center.



It was not her first time going under the knife. It was, however, the first time she had doctors use robotic equipment to operate on her.



“It’s different because the recovery is so short,” said Nagel, 84, of Wapakoneta. “I don’t experience a lot of pain that people with conventional surgery do.”



The morning after her surgery, she felt well enough to sit in an arm chair next to her hospital bed, smiling and laughing during conversation. Her daughter, Bernie, sat nearby and kept her company. Nagel was amazed she would likely be released from the hospital by the weekend.



“It’s so much simpler,” she said of the procedure.



And in many ways, it is simpler for the patient, said Dr. Craig A. Nicholson, director of Robotic and Minimally Invasive Surgery at St. Rita’s. For patients, incisions are more precise and there’s less blood loss than with traditional surgeries. Therefore, recovery times are quicker.



And depending on the kind of surgery, doctors can be much more specific with things they remove from the body. With the robot, the doctor can target the tumor within an organ, such as a kidney. Before robotic technology, the entire kidney would be removed.



“It’s amazing what we’re able to do with it,” Nicholson said.



It’s quite beneficial for doctors as well. Movements made on the robot are fine-tuned. The sway of a doctor’s hand may only move the robotic hand a millimeter, or a centimeter. Also, robotic hands can pivot 360 degrees, unlike the human hand. There are about 30 tools the doctor can switch in and out of the machine, depending on what he or she needs. The doctor can also magnify what he or she sees up to 10 times.



The robotic system includes three pieces in the operating room: The console, storing all the information needed during the surgery, the complex set of controls the doctor uses across the room and the machine itself that performs the operation above the operating table.



Exponential growth



St. Rita’s has trained many qualified doctors in the hospital to use the machines, using only the highest of standards, Nicholson said. Complications are lower than rates nationally for robotic surgery.



“We’ve been very, very careful,” Nicholson said.



And the minimal invasive surgery program is growing quickly — 168 percent over the past year, and tenfold since 2010. They received their first da Vinci surgical system in late 2010, and their second one last year. They each retail for about $1.5 million, but have proven to be an invaluable tool with qualified doctors using them.



In comparison, Mercy St. Vincent Medical Center in Toledo is celebrating 10 years performing robot-assisted surgeries. They own three da Vinci robotic surgical systems, and have performed about 2,000 robotic surgeries in the past decade. On their website, they’ve touted performing the most robotic surgeries in the region.



Lima Memorial Health System received their first surgical robot last year. They’ve performed about 160 procedures since receiving it.



So it shows that 1,000 robotic surgeries in about two and a half years at St. Rita’s is quite an accomplishment.



“For some things, we’re so far ahead of the curve. Particularly general surgery,” Nicholson said. “We’ve been doing it for a little over a year now.”



General surgery focuses on abdominal organs, including the esophagus, stomach, bowel ducts and gallbladder. Nicholson said general surgery has only been robotic-assisted for a few years anywhere.



Other robotic-assisted surgeries include hysterectomies, removal of female reproductive organs, and lobectomies, defined as the surgical removal of the lobe of any organ in the body — removing tumors from an organ, like a kidney or a lung.



According to Intuitive Surgical, the company that makes the da Vinci robot, less than 5 percent of colorectal surgeries are done via robot nationwide. In contrast, 35 percent of those cases are done robotically at St. Rita’s. The hospital performs about three-fourths of their hysterectomies with robotic assistance, versus 40 percent nationally. For lobectomies, less than 5 percent are done robotically nationwide; it’s at 14 percent at St. Rita’s and growing.



Looking ahead



Critics have said purchasing surgical robotic systems is costly for hospitals, and don’t provide any better outcomes than laparoscopic surgery, which uses cameras and small instruments on the operating table. But Nicholson disagrees. He sees the robotic technology as a major investment, only improving more over time, as technology advances and more doctors are properly trained across the country to use the equipment.



In addition to expanding the program more, he hopes for St. Rita’s to be a training grounds for robotic surgery advancements. And in a way, it has already been that way: Nicholson has proctored more than 200 surgeons from across the country.



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