Yampa Valley Medical Center surgeon Allen Belshaw uses the da Vinci surgical system to perform a gallbladder surgery at the hospital. The robotic surgery system allows the surgeons to make more precise movements by guiding a robotic arm via a console.

Courtesy/Stacy Childs

Yampa Valley Medical Center surgeon Allen Belshaw uses the da Vinci surgical system to perform a gallbladder surgery at the hospital. The robotic surgery system allows the surgeons to make more precise movements by guiding a robotic arm via a console.

Robot now being used in Yampa Valley Medical Center operating room

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— Surgeons at Yampa Valley Medical Center are turning to a robot to make surgeries more comfortable for them and their patients.

“It's just another tool, and we're very excited to have it,” Steamboat Springs urologist Stacy Childs said about the da Vinci Surgical System that recently was rolled out at the hospital. “I wish we had it four or five years ago.”

The robot assists surgeons, and the technology allows for patients to undergo fewer incisions, feel less pain and experience less scarring, according to the hospital.

“They usually go home the next day or the same day of the surgery,” Childs said. “That's one thing. It's less painful on the patient, and there's less recuperation time before they're back to work. That's a benefit.”

Before surgeons can use the robot, they must undergo extensive training and practice scenarios on a simulator.

Childs said the robot can make motions in three dimensions during a surgery with more precision than tools being held by the human hand.

“It's phenomenal what you can do with this machine,” he said.

It can be used during a variety of surgeries, including ones treating cancers of the prostate, ovary, endometrium and kidney.

Childs said he tracked 100 patients in his specialty in recent years who elected to go to other hospitals outside the Yampa Valley for surgery just because they had the robot.

He said that having the technology should allow patients to get treatment closer to home.

Childs said in addition to having benefits for patients, the robot makes surgeries more comfortable for the surgeons themselves.

“You can take your shoes off. You're sitting in a nice comfortable chair, and your head is resting on a viewfinder looking at this 3-D image with your forearms on a nice, padded rest,” Childs said. “That's comfy. That's a nice way to do an operation.”

The motions of the surgeon's hands, wrists and fingers are copied in real time by the robot during the operation.

Childs, the head of the hospital's cancer committee, said the technology also allows surgeries to be conducted with fewer assistants in the room.

“It's really a one-man show," he said.

The robot most commonly is used during gynecological procedures across the country.

Here in Steamboat, it has assisted four surgeries and is planned to be used in three this week, Childs said.

The robot was purchased with the assistance of a donation from an anonymous donor.

Hospitals across the nation are turning to robots to assist in surgeries, but the rollout of the new technology has been bumpy at times.

The New York Times last year reported more than 1 million surgeries had been performed by da Vinci systems throughout the past decade.

But thousands of mishaps also had been reported to the U.S. Food and Drug Administration between January 2000 and August 2012, according to The Times.

The Times reported a vast majority of the cases did not involve injuries to the patient, but the paper cited a study by The Journal for Healthcare Quality that reported there were 174 injuries and 71 deaths related to da Vinci surgery.

“There are always glitches in technology,” Childs said Thursday when asked about the past problems with the tool. “But this is all surgeon related. The robot does not do anything wrong. The surgeon is misusing the robot if there's a problem.”

He said he thought robot-assisted surgeries were here to stay, and the technology only is going to get better.

“This one fits our needs perfectly,” he said. “Ten years from now, they may be miniature. I can't even fathom what the newer generations of these robots will do. They may be doing things inside the heart and inside the brain. It's going to be phenomenal."

To reach Scott Franz, call 970-871-4210 or email scottfranz@SteamboatToday.com

Comments

Scott Wedel 5 months, 1 week ago

One of the more common criticisms is also that it inflates medical costs.

From a Kaiser Health article:

To date, hospitals, eager to attract patients with the technology du jour, have generally been willing to absorb the higher costs associated with robotic surgery. But health care overhaul provisions that encourage payments to providers based on "episodes of care" rather than individual services may begin to change these practices, say experts.

"As we move away from the fee-for-service model, we're going to discourage [procedures] that are no better than the higher priced one," says A. Mark Fendrick, director of the Center for Value-Based Insurance Design at the University of Michigan.

From a NY Times article: But the researchers did find a big difference in cost. Robotically assisted surgery for hysterectomy costs on average about one-third more than laparoscopic surgery.

“It’s important to separate the marketing from the data,” said Dr. Jason D. Wright, the study’s lead author, an assistant professor of obstetrics and gynecology at Columbia University Medical Center. “For the surgeon, there is a greater degree of movement and control of the instruments and the visualization is better.

“But the ultimate question is, does this change outcomes for patients? This study suggests that there really is not a lot of difference as far as quantifiable outcomes.”

From a Becker's Hospital Review article: "In gynecological surgeries, here is where marketing and capitalism and healthcare can all come together to produce a catastrophe" said Kenneth L. Davis, MD, President and CEO of The Mount Sinai Medical Center in New York City, at a public interview in April. "The da Vinci robot can be highly effective for prostate and some head and neck surgeries. However, it has to be in the hands of a very skilled, well-trained surgeon who has used it in hundreds or thousands of procedures," he said.

When the da Vinci is used for gynecological procedures, Dr. Davis said, "the surgery takes longer. The cost to the healthcare system is much higher. The outcomes aren't any better. But the doctors market it because people think, 'It's a robot, it must be unbelievable, right?' Somebody has to have sanity around this." When patients and payors are calling for reducing the cost of healthcare, Dr. Davis added, it's difficult to justify spending money on robotic equipment that isn't proven to be more effective or less expensive.

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Mark Ruckman 5 months, 1 week ago

Scott, did you happen to search for any articles that were not critical of this device?

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Scott Wedel 5 months, 1 week ago

Mark,

The quotes I included mentioned that there were situations in which it is more effective - " "The da Vinci robot can be highly effective for prostate and some head and neck surgeries. ..."

And the issue of costs is not just some doctor's quotes, they are commenting on studies that tracked outcomes.

On one level, it is nice that we have such a nice machine.

On another level, it is exactly this sort of expensive machine serving a small population that is why our nation's healthcare costs are so much higher than other developed countries that have overall better outcomes.

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mark hartless 5 months, 1 week ago

God bless this technology and all those who use it to save lives.

American's health care is outrageously expensive mostly because most americans never see a bill for the services they recieve, much less pay a portion thereof. If everyone had to pay a percentage of their bill then they would "shop around" and prices would be reigned in a bit.

I know it will never happen. Instead we will all be given "free" healthcare that includes less and less of this life-saving technology and medicine and treatment.

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