State-of-the-art innovations, such as the da Vinci Robotic Surgical System, are becoming standard tools in operating rooms across several specialties. In a recent appearance on the television program PBS HealthLine, Michael Grabowski, MD, PPG—General Surgery, highlighted how this technology is expanding surgical possibilities and enhancing patient care.
What are the benefits of robotic surgery for patients?
The combination of minimally invasive techniques and robotic surgeries has been shown to improve healing, reduce complications and shorten hospital stays. Procedures that were once considered complex and required long recoveries are now done on an outpatient basis, and the patient goes home on the same day.
With robotic surgeries, we see much better patient outcomes, and they experience less pain. Most of our patients with robotic surgery don't require opioids. A lot of them can manage their pain with basic anti-inflammatories.
It has truly transformed how we treat patients and what we can do to keep them out of the hospital. Hospitals are wonderful when you're really sick, but they're probably not great places to be if you don't need to be there.
Are most of these robotic surgeries done in hospitals, or are they moving to more ambulatory surgery centers?
It's a combination, and it depends on the region and the makeup of the surgery centers or the health system. In this region, many robotic surgeries are performed in hospitals, but that can change in the near future, especially with how rapidly the technology has developed.
One of the initial challenges of integrating these tools into a system was that the robot itself was an expensive unit and putting it in a surgery center was a little cost-prohibitive. But over time, we found that the benefits that patients gain from being able to do things on an outpatient basis mitigate those costs. Because of this, Parkview is actively working toward expanding access to robotic-assisted surgery in our ambulatory centers and outpatient facilities.
In general, complex procedures and robotic surgeries will continue in the hospital, but many operations will transition to an outpatient setting, which will make for a more positive patient experience.
What is the difference between outpatient surgery and inpatient surgery?
Robotic surgery is typically performed as an outpatient procedure in the majority of cases. Whether someone needs to stay overnight at the hospital as an inpatient often depends on the type of surgery, its complexity, the size of the procedure and other factors.
Not long ago, many operations required people to stay in the hospital for three, five or even ten days. We found that we can reduce the need for that now, and I would estimate that 80% of those surgeries or more are outpatient. This allows people to come in that morning, have their surgery and go home shortly after.
Is robotic surgery recommended for back surgery, such as spinal stenosis or disc issues?
Robotic surgery is manifesting itself in many areas, including spine surgery. This technology allows spine surgeons to use much smaller incisions. Another significant advantage is that the procedures have become much more precise. Surgeons are able to remove discs pressing against nerves with extreme accuracy because the robotic-assisted systems integrate directly with the patient's X-rays or MRIs, allowing them to see the surgical site in real-time and operate with greater control.
Check out this post for more on the many benefits of robotic spine surgery.
Are there any patients or procedures that aren't a good fit?
Currently, there aren't many limitations. One of the few challenges would be accessing the body cavity (abdomen or chest). Robotic heart surgery has lagged, to a certain extent, because of this. Limited space can make it difficult to position those smaller instruments. This can also include individuals who have undergone multiple procedures and have extensive scar tissue.
What new applications for robotic surgery are on the horizon?
Robotic-assisted procedures are increasing across all surgical disciplines. We're seeing them in pediatrics and almost every transplantation. Robots are even being developed for dental and oral procedures, especially for mouth cancers.
Another promising application is this technology's use for treating people who have breast cancer and performing mastectomies. Surgeons only need to make a small incision in the armpit and can use the robot along with visualizing technology to show where the blood vessels and differences in the anatomy are and dissect the tissues.
There are just so many opportunities in this area to continue advancing and expanding the care we're providing. With artificial intelligence and robotic-assisted machinery, I like to compare it to self-driving cars, which often receive bad press when they malfunction. But in reality, autonomous vehicles are equipped with a lot of sensors and technology that make driving safer. It can stop the car, recognize objects and adjust to changing environments. The same is happening in robotic surgery. The machine collects lots of data, and with artificial intelligence, it can analyze that information and ultimately limit the variation within procedures. There can be quite a bit of variation in the same surgery, depending on the surgeon, the patient and various other factors. Narrowing that variability means we can offer patients safer, more efficient and cost-effective surgical care.
To learn more about robotic surgery at Parkview, visit our webpage. Parkview Regional Medical Center is a Center of Excellence in Robotic Surgery and ACS Surgical Quality Partner. Click here to view our robotic surgeons of excellence.
