A da Vinci assists in
a prostatectomy at Montreal's Jewish General Hospital
Photo courtesy of the Montreal
Jewish General Hospital |
John Stella was pretty taken aback
when doctors at Montreal's Jewish General Hospital (JGH)
told him a robot was going to operate on his cancerous
prostate gland. The experience, however, turned out
to be incredible. "It's virtually painless, there's
only a bit of discomfort afterward," enthused the 52-year-old
at a press conference February 18.
On January 8, Mr Stella became
one of the first patients to be operated on by the latest
addition to the JGH's surgical team, the da Vinci S
HD robotic assistant. To remove the cancerous prostate,
Mr Stella's surgeon, Dr Maurice Anidjar, wielded the
da Vinci's four robotic arms via two tremor-eliminating
joysticks attached to a remote console with a 3D HD
screen.
NEW
TO THE NORTH
Only two other similar robots exist in Canada (in Vancouver
and Hamilton) along with three older models (two in
London and one in Montreal). The machine's $4 million
price tag makes it unlikely da Vinci robots will be
swarming Canada's hospitals anytime soon.
The JGH paid for the machine exclusively
through private donations. But the steep cost is worth
the results, said Dr Jacques Corcos, director of the
Robotics Program and urology chief at the JGH. "It has
become increasingly evident that prostatectomies performed
with robotic technology lead to a significant decrease
in incidence of sexual dysfunction and incontinence,"
he says. That equals a huge increase in the quality
of life.
These common complications can
have a huge affect on a patient's quality of life post-op.
So the surgeon's aim is two-fold: completely remove
the cancer, while preserving the nerves controlling
erection and the urinary sphincter. Robot assisted surgeries
have been shown to reduce the risk of these complications
as well as greatly cut blood loss and the amount of
recovery time spent in hospital from three to one and
a half days.
These reduced rates are thanks
to the robot's range of movement and fine motor skills,
said Dr Corcos. "It's incredible what the robot can
do in terms of movement," he explained. "It can do much
more than the human hand can." The machine's binocular
laparoscope, attached to its middle arm, also gives
surgeons a 3D view of the operation with up to 15x magnification,
allowing for greater precision.
AMERICAN
STANDARD
Since robots were first used for prostatectomies in
the US beginning in 2000, such surgeries have become
commonplace there. Nearly 70% of US prostatectomies
are carried out with the aid of a robot, according to
information from the JGH. Of the 700 similar robots
in use throughout the world however, about 500 are located
in the US.
Surgeons from the JGHs' team travelled
to the States to train on a robotic assistant before
the arrival of the new da Vinci system. "So far the
surgeries are still slow, but it's because there's a
learning curve," said Dr Anidjar.
In the coming months da Vinci will
start assisting kidney cancer operations as well as
cardiac surgeries to repair valves, congenital holes
and remove tumours at the JGH. Matter-of-factly Dr Corcos
said, "It's the surgery of tomorrow."
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