SEATTLE, Sept. 22, 2005 - Swedish Medical Center has established a new robotic surgery program and acquired the latest generation of robot-assisted surgical technology. As the first of its kind in Washington state, the new four-armed da Vinci Surgical System provides a precise, minimally invasive way to help a trained surgeon remove a cancerous prostate gland by using finely controlled robotic instruments to perform the procedure more safely, while speeding patient recovery.
James Porter, M.D., the leading laparoscopic urologic surgeon in the region, is the new medical director of robotic surgery at Swedish. Previously, he served in a similar position at the University of Washington Medical Center. As the first physician in the Northwest to have performed a laparoscopic prostatectomy, Dr. Porter is still just one of a few surgeons in Washington state qualified to perform a robot-assisted prostatectomy.
"The new robot changes almost everything about the experience of prostate-cancer surgery for both the patient and the surgeon," said Dr. Porter, who performs both laparoscopic and robot-assisted prostatectomies at Swedish Medical Center's First Hill Campus. "It takes us a big step beyond either open surgery or traditional laparoscopy."
Until recently, men choosing prostate-cancer surgery had only open surgery as an option. In a conventional radical prostatectomy, surgery involves making large open incisions in the lower abdomen. The pain and recovery associated with the procedure can be significant.
The da Vinci Surgical System allows for the removal of the gland by making just five small incisions, each about a half-inch long. For patients, that means shorter hospital stays, less pain, less risk of infection, less blood loss and fewer transfusions, less scarring, faster removal of the urethral catheter, a faster recovery and a quicker return to normal activities. In addition, there is growing evidence that robot-assisted surgery leads to greater cancer control, an earlier return of urine function, and enhanced preservation of sexual function.
How It All Works
The latest da Vinci Surgical System has three main components:
- A mechanical robot with four multi-jointed arms
- A computer command center installed several feet from the patient, where the surgeon sits. This console also includes a 3-D monitor similar to a "viewfinder" that provides the surgeon with a magnified view of the surgical site inside the patient
- And a vision cart, which the surgical assistant uses to observe the procedure
Equipped with a special, dual-lens endoscope, the viewfinder provides a very magnified view of the surgical site inside the patient. It allows surgeons to see the surgical site up to 12-times more closely than human vision allows. It also enables physicians to work more precisely and at a smaller scale of detail than in conventional surgery.
While sitting at the console, a surgeon controls a high-resolution camera and micro-surgical instruments. The computer scales the surgeon's movements, precisely guiding the robotic arms. Unlike traditional laparoscopic micro-instruments, da Vinci instruments have a patented EndoWrist that can turn 540 degrees, allowing for much finer movements. This is particularly important in sparing the delicate nerves that control bladder and sexual function.
"With robot-assisted surgery, we can virtually put our hands inside the patient," Dr. Porter explained. "The robot's arms bend naturally around corners and essentially eliminate surgeon hand tremor."
Dr. Porter believes that over the next decade robot-assisted prostatectomies will become the most common surgery performed on men with prostate cancer.
Over the next few years, Swedish intends to train other surgeons on the da Vinci Surgical System, including OB/GYNs, cardiac surgeons, thoracic surgeons and others as the scope of this technology expands.
The da Vinci Surgical System at Swedish cost $1.5 million, all of which came from private donations made through the Swedish Foundation.
A Few Prostate-Cancer Facts
- Prostate cancer is the second most common form of cancer in males
- An estimated 230,000 men will be diagnosed with the condition this year
- More than 70 percent of men diagnosed are 65 or older
- African-Americans have a significantly higher risk of prostate cancer than caucasians
Swedish Medical Center is the largest, most comprehensive, nonprofit health provider in the Pacific Northwest. It is comprised of three hospital campuses (First Hill, Providence and Ballard), a new community-based emergency room and specialty center in Issaquah, Swedish Home Care Services and Swedish Physicians - a network of 12 primary-care clinics. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiac care, oncology, orthopedics, high-risk obstetrics, neurological care, sleep medicine, pediatrics, organ transplantation and clinical research. For more information, visit www.swedish.org.