Vail Health hosted held an event Wednesday, May 25, to let the public see the Da Vinci robotic surgery tool first hand. The robot translates human movements into robotic ones, and Vail Health reports successful outcomes after using it for almost a year and a half.
The robot can turn a pinching of the thumb and forefinger into the electronic clamping of surgical forceps or almost any other surgical instrument.
For some patients, the term Da Vinci is a mystery, Vail Health VP of outpatient services Stephanie Kearney said.
“It’s an unknown term,” Kearney said.
The machine’s four arms hang above the patient. The surgeon controls the arms and camera from a nearby console. Dr. Turner Lisle said the doctor is always in the same room.
Referencing a procedure performed on the Da Vinci predecessor, ZEUS, Lisle said, “They did a transatlantic cholecystectomy. I can’t fathom how they did that in 2001. We would never consider doing that now.”
He said communication between the surgical team at the patient’s side and the operating surgeon was important to successful surgeries, and he wouldn’t want bandwidth limitations to get in the way.
The primary advantage of the Da Vinci comes in its minimally invasive impact. Instruments and cameras are small enough to fit through key-hole sized incisions, meaning less scarring and less time needed to heal. Despite their small size the instruments have full articulation.
“It can articulate just like the human wrist,” Lisle said. The old standard of “straight sticking,” or using a straight claw-like tool with only the ability to open and close, often resulted in more tissue trauma and abdominal pain during laparoscopic surgeries, he said. The Da Vinci allows for more advanced movements and less trauma, as the increased articulation allows the operator to navigate the abdomen less clumsily and with more precision.
Less pain and a fewer incisions also means a quicker return to activity. He said patients can return to physical activities within days of an operation. Speaking generally, he said normal six to eight week recovery times become reduced to 10 to 14 days.
The Da Vinci is not a replacement for doctors, and neither is it a crutch. Lisle said the Da Vinci does not make a bad surgeon good.
“It makes a good surgeon better,” he said, by allowing the surgeon to perform more complex operations.
Operations around the wall of the anterior part of the abdomen, he said, in particular can be difficult. With the patient lying face up, the surgeon has to find a way to operate on the underside of the abdominal wall while standing above the body. The Da Vinci makes this easy with its articulation and ability to reach down and back up like a fish hook.
While the surgeon needs to be in the room, a consulted surgeon does not. Lisle said if another surgeon using the Da Vinci needed advice from another doctor, they could live stream the Da Vinci’s camera feed to a smart phone.
Since its implementation in Dec. 2020, Vail Health has seen a decrease in complications and opioid prescriptions.
“We decreased narcotic prescribing 75% across the board on average,” Lisle said when comparing robotic surgeries to standard laparoscopic surgeries. Vail Health reports opioid prescription after inguinal and ventral hernia repairs dropped 83% and 82% respectively when compared to open surgeries.
Likewise, data from Vail Health shows complications due to surgery decreased significantly compared to national averages. It also reports no complications due to surgery or surgical site infections.
Vail Health’s robotics program has handled 370 cases to date. Of those, 319 were general procedures or hernias, 32 were urologic, and 19 were gynecologic.