Q: When did you first become involved with robotic surgery?
A: I was introduced to it in medical school. I rotated with a general surgeon who was using it in its early stages. It wasn’t really available for a lot of complex operations, but we were doing gallbladders and hernias. I was enticed by how amazing the visualization was and how precise it allowed the surgeon to be, especially in comparison to standard laparoscopy, and by being able to perform the most precise types of surgery in a minimally invasive fashion. In residency, I took every robotic general surgery case that I could, and my passion and interest grew. We were starting to perform the more complex operations like colorectal surgery, and it became clear why this technology is so extraordinary.
Q: How would you define robotic surgery?
A: It’s a complex surgical tool. The advances in the software and visualization — the instruments we use — allow for a lot more complexity. Minimally invasive surgery encompasses both laparoscopic and robotic laparoscopic surgery. [Robots] are an extension of the surgery that we are able to do, using instruments that go through small incisions; the instruments are attached to arms that we control completely on the inside from a console away from the operating table.
Q: Could you explain the “human element” of this technology?
A: The robot doesn’t have any autonomy, but it does perfect a lot of things that humans can do. For example, high-definition vision and perfect depth perception. Even though we control the instruments, they have articulation. Through tiny incisions they can move like the human wrist. You don’t have to have your whole hand in the abdomen. What that enables is getting really close and seeing vessels and nerves and protecting them, and even being able to suture the smaller structures. With the robotic system, we can also [access] areas in the abdominal cavity — such as the pelvis or near the diaphragm — that would be very difficult to reach in an open fashion. Those surgeries use a special gas to lift the abdominal wall out of the way so we can see and manipulate the organs. The advantages for the patient are huge.
Q: What about the advances being made in this field?
A: I’m very excited about the new instruments. We’re seeing this every year. We are already doing a lot of complicated surgeries with this platform, but I think it will just get better in the sense that the instruments will allow us to have shorter operating times. I think it will be adopted by other surgical specialties as well.