Mayo Clinic surgeons are performing robot-assisted procedures

Wednesday, August 31, 2005

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JACKSONVILLE, Fla., Aug. 31, 2005 — Surgeons at Mayo Clinic in Jacksonville, Fla., were the first in the region to use robotic assistance in the operating room for a procedure to correct urogenital prolapse. The condition, which is particularly common in older women, occurs when pelvic floor muscles and ligaments weaken, causing the organs they normally support to push against the walls of the vagina. Mayo surgeons use the robot for other gynecologic and urologic procedures as well. They anticipate robot-assisted surgery will decrease blood loss, shorten hospital stays and recovery times and improve quality of life for patients.

After her robotic-assisted surgery, one patient, who asked not to be identified, spent two nights in the hospital, about half the time she would have if the surgery had been done through an open incision. "I'm the caregiver for my husband. And when you have two people sick in the house, it's two too many," she said. "And of course to have the regular procedure done would have involved six to eight weeks just trying to take care of myself."

For robotic-assisted surgery, small incisions are made in the patient through which surgical instruments and a miniature camera held by robotic arms are inserted. The surgeon controls the movement of the instruments and camera at a console in the operating room equipped with a special three-dimensional monitor and intuitive hand controls.

"With robotic assistance, we're able to take laparoscopic surgery a big step forward," says urogynecologist Dr. Anita Chen. Traditional laparoscopic surgery is done with surgical instruments inserted through small incisions, but the surgeon handling the instruments has a limited range of motion. Additionally, the surgeon can only see what he or she is doing on a two-dimensional monitor. "With the robot, we're able to visualize the procedure in three dimensions, and the robotic instruments duplicate the motion of our wrists," Chen says.

A robotic-assisted surgery.

"At Mayo, we're experienced at doing many laparoscopic, minimally invasive procedures," says urologist Dr. Todd Igel. "The robot allows us to expand laparoscopic surgery to the procedure for prolapse, reconstructive kidney and urinary tract procedures and prostate removal."

Indeed, the most commonly performed robotic-assisted procedure is radical prostatectomy — the removal of the prostate gland. "Urology leads the way in robot-assisted surgery because the prevalence of prostate cancer is so high," Igel says. "Many men with prostate cancer are appropriate candidates for a robotic-assisted procedure versus an open procedure."

At Mayo Clinic, a standard radical prostatectomy is done through a 3- to 4-inch pubic or perineal incision. With a smaller incision, men can expect to go home sooner and recover faster. Surgeons suggest robotic precision will translate into better neurovascular preservation, which should lead to fewer incidences of incontinence and impotence resulting from surgery.

"We're still in the infancy with robotic-assisted surgery," says gynecologic surgeon Dr. Paul Pettit, "but we hope that long-term results of the robotic-assisted procedures will be as good or better than those with the current open procedures."

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Mayo Clinic is the first and largest integrated group practice in the world. The staff in Jacksonville, Fla., includes 312 physicians working in more than 40 specialties to provide diagnosis, treatment and surgery. Patients who need hospitalization are admitted to nearby St. Luke's Hospital, a 289-bed hospital operated by Mayo Clinic. Mayo Clinics also are located in Rochester, Minn., and Arizona. Visit www.MayoClinic.org/news for all the news from Mayo Clinic.

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