No longer science fiction, robots assisting surgeons
October 20, 2009
By David Hayes
New technology helps clear Issaquah man of prostate cancer
John Malina led a healthy lifestyle. The Issaquah resident had eaten healthily, worked out regularly and didn’t have any hereditary diseases that ran in his family.
So, the 64-year-old was rather surprised to be diagnosed with prostate cancer in 2007.
“I was shocked, to tell you the truth,” he said. “I never expected it.”
When discussing treatment options with his urologist, Malina learned they caught the cancer early on, when it wasn’t aggressive yet, giving them several options. He was surprised one of the options seemed right out of science fiction — robotic surgery.
“I have a son serving in Iraq,” Malina said. “He told me the Army was already using robotic surgery, even on the battlefield, and it seemed to be working out well. I wasn’t even aware it was being used locally.”Malina’s urologist, Dr. Joel Lilly, practicing since 1990, is one of a growing number of surgeons utilizing the new technology at Swedish Medical Center. He’s already approaching his 200th case using the robot-assisted surgery and Swedish has notched more than 2,000 since its invention.
“Patients hear their diagnosis and are anxious to get the cancer out of their body,” Lilly said. “The technology makes the surgery a lot less of a scarier proposition.”
Like operating an oversized flight simulator, the robotic apparatus comes in two parts — the surgeon sits at the first large consul at the side of the operating table, operating two actuators (joysticks for computer gamers) and foot pedals. The controls remotely operate four robotic arms — one a binocular camera giving him a 3-D view with two lenses, and three arms to hold the instruments for the operation.
“It’s pretty amazing technology,” Lilly said. “I’m excited to be working in an era to get to use it.”
All this technology essentially uses a smaller footprint to perform a surgery that in the past was quite invasive.
The conventional surgery used to require a six-inch incision in the lower abdomen; caused considerable blood loss requiring a transfusion that made the patient anemic; mandated a two- to three-day stay in the hospital for recovery, followed by two to three weeks with a catheter inserted into the bladder; and a lot of pain, Lilly said.
Now, the robotic surgery makes only eight to 12 tiny holes of one-third to one-half inch, which are easier to heal and cause less pain; patients are released a day after surgery, and the catheter is only needed for one week.
Malina said he decided to go the surgery route, because he wanted the round of chemotherapy to be a fallback if the surgery didn’t work. It’s looking like he’s made the right decision.
“While I was in the hospital two days, I recovered fairly quickly,” he said. “They got it all out before it could spread past the prostate walls. So, I should be cured.”
Malina said the surgery last November hasn’t slowed him down. He feels good, has a lot of energy and is back to eating right and working out. He said he thinks the robot-assisted surgery is a fabulous medical development.
“Anything that improves the eyes of a surgeon should play a huge role in any surgery,” he said.
Lilly added that robot-assisted surgery is being used in other areas, such as kidney procedures, ovarian cancer, and thoracic and heart surgeries.
The technology is continually expanding, he said. For example, the robotic arms provide a “feedback loop” that, using sensors, tells the surgeon when pushing on something how much pressure and resistance the arm is meeting.
“The bottom line,” he added, “is the robot-assisted surgery is making many of the surgeries of the last 20 years less invasive.”
Malina said he’s grateful the technology has helped him nip in the bud an insidious type of cancer, especially now that he’s approaching two years clean.
“I’m happy to talk to anyone about the experience,” he said. “A friend of mine was facing the same situation. I was happy to recommend to him robotic surgery. I’d recommend it to anyone.”
David Hayes: 392-6434, ext. 237, or firstname.lastname@example.org. Comment at www.issaquahpress.com.