Keck doctors perform new robot-assisted procedures

This summer, Dr. Jeffrey Hagen and Dr. Daniel Oh of the Keck School of Medicine of USC became the first doctors in Southern California to perform robot-assisted procedures with the new da Vinci Xi machine. Da Vinci robots, manufactured by the robotic surgical systems producer Intuitive Surgical, have been used worldwide since the Food and Drug Administration approved the first model of the machines in 2000.

According to USC News, the Keck Medical Center of USC is the only facility in the world that has a training center for da Vinci technology.

The brand new Xi model received FDA approval on April 1 of this year. It includes a simpler and more compact endoscope, an instrument that is used to look inside the body, with improved vision and clarity of image, smaller, thinner arms to allow for a greater range of motion and a longer instrument shaft for greater reach. To date, the most common procedures performed via da Vinci robots are hysterectomies (removal of the uterus) and prostatectomies (removal of the prostate). These improvements allow for more intricate applications, such as the thoracic surgery performed on a lung cancer patient by Hagen, who is chief of thoracic surgery, and Oh.

Da Vinci technology also enables surgical procedures to be performed remotely, allowing surgeons to utilize their skills from afar. Past surgeries using similar robotic technology have included a transatlantic telesurgery performed in 2001, when surgeons at Mount Sinai Medical Center in New York removed the gallbladder of a 68-year-old woman in Strasbourg, France.

Robotic technologies improve operations with wristed instruments that allow for more dexterity as well as minimal incision sizes, shorter hospital stays and faster recovery periods for patients.

Though robot-assisted procedures are often compared to laparoscopic surgery, robotic procedures cost approximately $1,300 more on average per surgery than those performed with laparoscopic devices. Laparoscopic surgery utilizes small incisions typically made in a different area than the part intended for surgery.

According to Reuters Health, however, few doctors are skilled enough to perform laparoscopic surgery. Robotic surgery allows more patients to have access to minimally invasive surgery.

Hagen pointed out that robotic technology was not meant to compete with laparoscopic procedures and that robotic technology should be viewed in terms of the advantages it provides over traditional open surgery.

“As of 2012, 85 percent of prostatectomies have been performed using robotic technologies, while less than 1 percent have been performed laparoscopically,” Hagen said.

For Keck students and faculty, having the da Vinci Xi machine represents their advanced expertise. Hagen also said that the robotic surgery program at Keck is the largest in the state of California and likely in the western United States. The program offers training across a broad range of specialties and is well recognized nationwide.