"Amazing technology:" Hospital celebrates new da Vinci robot

It may sound strange - a robot to help with surgeries. 

And certainly, the da Vinci robotic system itself looks intimidating. Standing taller than a human with its white boom and four robotic arms with instruments attached, it may seem like something out of a sci-fi movie. 

"It's a little bit scary looking," Dr. Brianne Crofts admitted, but she added that "at the end of the day, it's not scary."

Even apart from its looks, the thought of a robot performing surgeries may be what comes to people's minds when they hear about the da Vinci machine, which can raise questions and concerns.

Dr. Crofts noted that people hear the word "robot" and immediately think the hospital is using a machine to do all the work, but she quickly corrected that perception as well. 

"It's a tool. It is a machine and it has tools on it, but I'm in control," she explained. "There's no artificial intelligence. I'm just in control of it." 

But even Dr. Crofts was skeptical when she first heard of the da Vinci robotic system. As a general surgeon who has been at Memorial Hospital of Sweetwater County for 13 years, she wasn't sure why she needed to learn something new when she was already good at her skill set. 

Then she saw the da Vinci robot in action and got to use it.

Now she can barely contain her excitement when she gets to tell people about how "amazing" the machine is. 

"After completing my training and doing a couple of cases, I can definitely see why surgeons support this technology," Crofts said. 

Working with the machine 

The da Vinci robotic system is designed to give surgeons high-definition 3D vision, a magnified view, and robotic and computer assistance while performing surgeries. 

"It provides us the ability to take laparoscopic skills that general surgeons have, but to use technology that gives us the ability to essentially use what feels like your hands in the patient," Dr. Crofts said.

Laparoscopy uses small incisions, a camera and other instruments to do a surgery, but traditional laparoscopic surgeries are "essentially operating with chopsticks," according to Crofts. Since those instruments are basically sticks, they can't articulate and move around. The instruments on the da Vinci robot, however, have the ability to articulate like a wrist, giving the surgeon more freedom of movement. 

Crofts said one way she's described it is imagining the surgeon can be shrunken down, like on "The Magic School Bus," allowing them to do the operation from the inside. 

Surgeries using the da Vinci system involve a bedside assist, such as a scrub tech or nurse, staying with the patient and the machine, but the actual surgeon scrubs out once the machine is set up and goes to an operating console to control the instruments. 

"That allows the surgeon to take their motion on the controller and it's translated to the instrument that's attached to the patient to perform the action that you're doing," Dr. Crofts explained. "It's awesome."

But perhaps even more awesome than the range of movement the da Vinci machine allows is the visuals it provides. 

"I think the greatest thing about it is just what the surgeon sees," Crofts said. "It's something that you can't describe unless you're sitting there using the machine." 

The 3D vision provided by the machine and its miniaturized surgical camera allows the surgeon to see details they can't see during traditional laparoscopic surgeries. It can show things like tissue planes that the surgeons have always known existed but have never been able to directly observe before, letting them take the things they've learned about and experience them directly, which Crofts described as "beautiful." 

Having a better view also allows the surgeon to be even more precise while operating.

"I do think it's a great thing that the hospital has purchased this technology for us to use on our patients here in Sweetwater County," Dr. Crofts said. 

Bringing the da Vinci robot to Sweetwater County 

The process of bringing this new technology to Sweetwater Memorial started a little over a year ago, Crofts recalled. 

One of the forces that set the process in motion was the retirement of Dr. John Iliya from general surgery at the hospital. While Dr. Iliya is continuing to serve as the medical director for Hospice of Sweetwater County, the end of his time as a general surgeon brought up the hospital's need to hire a new general surgeon to take his place. 

Ideally, the hospital's plan was to recruit a new general surgeon who was young, even someone just coming out of training, so they could have longevity with the hospital and serve the community for years to come. These days, most of the resident physicians coming out of general surgery training have been trained on the use of the da Vinci robot as part of their skillset. Without having a robot for them to use, it would be hard to attract them to the hospital. 

"In order for us to continue to provide general surgery services in our county, it was something that the hospital really had to look at buying in order to make that service line continue here," Dr. Crofts explained. 

It was Dr. Augusto Jamias, the other general surgeon at Sweetwater Memorial, who especially got the ball rolling, spearheading the investigations into the da Vinci system and recommending the hospital purchase it. He also got ahead in training to use the machine. Despite her initial skepticism, Dr. Crofts was on board as soon as she used the machine herself. 

Training on the da Vinci system is provided by Intuitive Surgical, the company that manufactures the robot. It involves case observation, online modules, using the robot on models, and working with Intuitive representatives. 

"Your laparoscopic skills do translate into the robot, so it's not like you have to learn new skills per se," Crofts said. "It's really understanding the machine, how it works, how you make it work for you, and then how to troubleshoot if something's not working for you."

After watching other people use the da Vinci robot, training on it, and using it herself, Dr. Crofts said she now feels "very confident using that machine."

The da Vinci robot at Sweetwater Memorial was used for the first time at the beginning of the summer by Dr. Jamias, and has now been used by both Dr. Jamias and Dr. Crofts. So far the robotic system has been used on about seven to ten cases, Crofts estimated, all of which have gone great. And the system will continue to be used for many more surgeries in the future. Crofts also noted that a new general surgeon will be coming to the hospital in September, and since that surgeon has already received training on the system they should be able to "hit the ground running" and start using it right away. 

Putting patients first

When it comes to bringing new technology to Sweetwater Memorial, the focus is on helping the patients. 

"Any time we have new technology, we want to make sure, 'is it safe?'" Dr. Crofts said. "So obviously the da Vinci robot has proven to be safe. And then we want to say, 'how does it affect patients?'" 

The ultimate goal is always safety as well as finding new ways to help patients, according to Crofts. 

"I do think that the patients do benefit from this technology," she said of the da Vinci system. 

Some of the benefits include patients potentially experiencing less pain and a faster recovery time than they would with open surgery or even traditional laparoscopic surgery. Crofts noted that the hospital strives to make sure the outcome of all surgeries are equivalent across the board, and added that traditional surgery methods are still effective and patients can do well with them. However, the goal of minimally invasive surgeries is to reduce pain and suffering, and the da Vinci system provides the potential of achieving this goal even more efficiently. 

As a surgeon, Crofts hopes the added benefits she gets from the machine translate into added benefits for the patient as well. 

"I almost feel like I'm doing a better job," she said of using the machine. 

The da Vinci system will mostly be used for surgeries like gallbladder removals and hernia repairs, according to Crofts. The machine also has the potential to be used for cases including prostate conditions, colorectal surgery, gynecologic conditions, pancreatic disease, kidney disease, urologic surgery and stomach cancer. Crofts also noted that not every patient will be a candidate for the use of the robotic system, but for those who have a surgery need that can be fixed with the system, it is an option they can use. 

"I think that people need to know about it and what it has to offer," Crofts said of the da Vinci system. "I do think it's great technology and it's very beneficial."