MURRAY On the operating table, the plate is about the size of a small saucer, with little rubber bands and spongy forms sticking out.
On the monitor and through the eye pieces of the new-generation surgical robot, which Intermountain Medical Center surgeons used for the first time this week after extensive "practice" sessions, it fills the whole screen, the detail sharp and about 12 times its real size. The plate and its rubbery contents are part of the training in use of the device.
The da Vinci S HD Surgical System ties three-dimensional, high-definition endoscopy and the newest robotic technology together to let a surgeon control the four robotic arms from a console several feet away in what Dr. Jay Bishoff, medical director of the Intermountain Urologicial Institute, described as "remarkably precise and exact" motion.
IMC is the first hospital in the region to use the new system, although other iterations of a surgical robot have been used by asatch Front hospitals for some time.
On Monday, urologists at IMC performed two radical prostatectomies, removing all or part of prostate glands. Eventually, the robotic device will be available for general surgery, heart surgery and obstetric and gynecologic procedures.
This latest da Vinci has some improvements over earlier versions, starting with the all-digital, high-definition imaging. That, Bishoff said, isn't as important for some surgeries as for others. You'd definitely appreciate it if you were doing mitral valve repair, for instance.
It also has smaller arms (less bumping into each other and the scrub staff) and the ability to move the instrument flexibly. It mimics the motion of the human wrist.
Among the advantages to robotic surgery, said Bishoff and fellow urologists Drs. Scott Putman and L. Scott Chidester, is somewhat shorter hospital stays, less blood loss (the "ports" through which the robot-controlled instruments are inserted into the body are very small) and quicker return to activities.
In the case of surgery to remove the prostate, the robotic approach also may reduce the risk of complications such as loss of bladder control and erectile function, they said.
But it's not for everyone, and there are many good, effective ways to treat prostate cancer, Bishoff added. The surgeon and patient have to consider different issues to decide on treatment. Patients who need extensive abdominal surgery or who have had previous abdominal surgery, for instance, are likely not candidates for a robotic prostatectomy.Robotic surgery is somewhat more expensive because of the cost of disposable equipment. But it's also somewhat cheaper in terms of in-patient costs, which helps balance things out, they said.
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