Robotic Surgery

The Development of Robotic-Assisted Surgery

The past two decades have witnessed a revolutionary transition in surgical technique and technology. Traditionally, surgeries had been performed in the open manner, in which large incisions were required for the surgeon to plainly observe and manipulate the surgical field. These incisions inevitably created significant patient trauma—substantial pain and suffering, extended recovery time, prolonged pain management and elevated costs.

Minimally Invasive Surgery

Approximately 20 years ago, surgeons began practicing a new approach to performing surgery, an approach that came to be known as minimally invasive surgery, or MIS. During this era, tiny cameras in instruments called endoscopes or laparoscopes were introduced. These visual and surgical aids could be inserted in the patient's body through small ports.

Although revolutionary in its positive effect on patient trauma and recovery times, MIS encountered significant technical drawbacks. The surgeon operated using a standard 2D monitor instead of looking at his or her hands. The resulting image flattened the natural depth of field, and the fixed-wrist instruments limited his/her dexterity. The lack of 3D visualization of the operative field, the poor ergonomic design and reduced control were major roadblocks to further progress. As a result, this type of MIS turned out to be suitable for a narrow range of surgical procedures.

Robotic-Assisted MIS

In the late 1990s, another evolutionary stage in the development of surgical technique was achieved with the application of robotics to surgical technology. At the forefront of this new era, Intuitive Surgical introduced the da Vinci® Surgical System. The da Vinci System features wristed instruments with seven degrees of freedom, three-dimensional, intuitive visualization and ergonomic comfort. These innovations created the preconditions for minimally invasive solutions to complex procedures in a wide range of surgical specialties. Today, Intuitive Surgical's products continue to enable a new generation of surgical advancements, providing benefits to surgeons, hospitals and patients. text reproduced from www.intutativesurgical.com

On October 11, 2004, Southern Illinois University entered the robotic age with the region’s first robotic assisted surgery. The Urology division at SIU is spearheading the St. John’s Hospital robotic surgery program by performing three different urologic procedures by two surgeons. Dr. Brad Schwartz, Associate Professor and Director of Laparoscopy, Robotics and Endourology and Dr. Tom Tarter, Associate Professor and Director of Urologic Oncology have together performed more than 40 robotic procedures since the hospital acquired the DaVinci robotic platform by Intuitive Surgical.

Dr. Schwartz’s expertise with the robot lies in kidney reconstruction and female pelvic surgery. The two procedures best designed for the robot in his practice are the pyeloplasty for ureteropelvic junction obstruction and the sacrocolpopexy for pelvic organ prolapse. He has teamed up with Dr. Pat O’Donnell, Professor and Director of the SIU Center for Continence to provide this innovative surgery to women who will benefit from this procedure. Dr. Tarter performs robotic radical prostatectomy in men who have prostate cancer. Visualization and appreciation of structures and anatomy is unparalleled compared to other current technologies. Both surgeons feel that the benefit of the robot is immeasurable and feel fortunate to have the technology available in Springfield.