Robots in the O.R.

Robots in the O.R.

Better operations through the use of intelligent machines

The future of surgery is here, and it’s in the hands of robots. Well, sort of.

The first robotic surgery system, the da Vinci robot, produced by Intuitive Surgical, was approved by the FDA in 2000. The robot, now in its fourth generation, has become a mainstay at Chicago’s leading hospitals, where both physicians and patients are seeing shocking results.

With the robot, surgeons are getting one step closer to being able to perform “the perfect procedure,” says Pier Cristoforo Giulianotti, MD, chief of the Division of General, Minimally Invasive and Robotic Surgery at UI Health. And by all accounts, they’re getting there quickly. 

Empowering surgeons

Laparoscopic surgery — minimally invasive surgery using small incisions and a special camera known as a laparoscope — has increasingly become the method of choice among surgeons, offering less biological trauma and shorter recovery times for patients than open surgeries. The da Vinci robot takes laparoscopy a step further, optimizing not just the procedure, but the surgeon performing it. 

At UI Health, surgeons now use the da Vinci robot to perform a majority of their general procedures, including surgeries on major organs like the colon, lungs, pancreas, liver and stomach, as well as tumor removals. It makes all the difference, Giulianotti says, particularly forcomplex surgeries like pancreatic tumor removals where a minimally invasive approach otherwise wouldn’t be feasible. 

During a robotic procedure, the surgeon sits comfortably at a console where master controls allow him or her to precisely maneuver surgical instruments affixed to robotic arms. A high-definition, 3D camera allows the surgeon to view inside the patient’s body with amazing detail. The natural tremors of the surgeon’s hands are erased, replaced with the exact, perfected movements of the robotic wrists. 

By contrast, traditional operations, like the Whipple procedure used to remove pancreatic tumors, may require six hours of continuous work. Standing and working for so long inevitably leads to fatigue and, by default, less accuracy. 

It’s an improvement not just on traditional surgery, but laparoscopy as well, says Shari Snow, MD, chief of Gynecology and Minimally Invasive Surgery at UChicago Medicine. The robotic tools allow for much more natural wrist-like movements and defter turns than laparoscopic tools. It’s like the difference between tying your shoelaces with wrist splints on versus without, Snow says.

Better procedures, better results

Above all, the benefits of robots extend to the patients. Snow, who uses the da Vinci robot to perform procedures like hysterectomies and fibroid removals, says her patients experience significantly less pain and scarring with robotic surgery, and they’re back to their daily lives much faster than with traditional abdominal surgery. 

The benefits of robotic surgery are especially important for patients undergoing tumor removal. The robot helps in “maintaining the integrity of the human body,” Giulianotti says. A significant reduction in blood loss and tissue damage means the immune system can remain focused on fighting the cancer instead of being redirected to heal the effects of surgery.

Patients are stronger and in less pain, and they can start chemotherapy in three to four weeks instead of waiting the minimum of two months generally required after a traditional tumor resection. There isn’t enough statistical data yet to give a clear indication of how the robot improves survival rates, Giulianotti says, but, he adds, “all the trends are in favor of better survival.” 

Surgery is being rapidly improved by intelligent machines like the da Vinci robot, and we’re only at the beginning. In the future, surgeons may be able to perform procedures remotely, providing access to key surgeries in areas where they previously weren’t available. And integration between the robots and other emerging technologies like artificial intelligence and augmented reality will mean even more possibility and precision. 

Giulianotti sees a future where a surgeon will be able to pinpoint specific areas affected by cancer, remove that tissue with robotics and leave everything else intact. “One day we’ll be able to enter into the human body to make a repair without pain, without scars, without blood loss,” he says. “The perfect operation.”


Above photo: da Vinci robotic surgery system. Photo courtesy of UI Health