Technology continues to change the medical landscape in a multitude of ways. Among the latest examples is how certain surgeries are handled.
In traditional surgery, doctors cut a patient open with a scalpel and work with several tools over a few hours until they’ve completed their task and patched the area up.
But at some Delaware hospitals, surgeons have another option: Perform the operation with a robot.
In a small exam room at Nemours Alfred I. duPont Hospital for Children in Rockland, 14-year-old Dale Messinger sits quietly. Nemours pediatric urologist and Director of Robotic Surgery Jennifer Hagerty is showing him the results of a follow-up ultrasound in May.
“There’s your bladder, which looks normal,” Hagerty explains to him. “There’s your right kidney. There’s no more of that black in the center area. There’s no swelling in the center at all. Looks great. Looks normal.”
Dale had surgery on Feb. 1 for a kidney blockage. The surgery was done by a three-armed robot called the da Vinci Surgical System.
At Nemours, they call the robot Surgeo.
Within a week, Dale was able to play outside again. But before the surgery, the pain in his stomach was “like a stabbing and like a sword sensation,” he said.
Three months after the surgery he said, “I feel perfect now.”
Dale’s surgery is one of around 250 performed by Surgeo. Nemours mostly uses the robot for urology, ear, nose and throat procedures and sleep apnea.
With three robotic arms that hold a camera and surgical tools, Surgeo can make three tiny incisions.
But he doesn’t work alone.
A Nemours surgeon engages the robot by putting their head in a nearby console. They slide their fingers into grips and put their feet onto pedals that allow them to control Surgio’s arms and the energy of the instruments.
Then, they follow instructions on the screen telling them how to use the tools. It’s kind of like controlling an avatar in a video game.
“When I sit down at the surgeon's console where I sit, I’m moving specifically the angles of the instruments and that’s translated through to Surgeo,” Hagerty said. “So Surgeo can only make those movements that I’m making it move.”
Hagerty let Delaware Public Media demo a surgery in the belly in April. This reporter struggled to use the tools and discovered she would be a terrible surgeon.
Surgeo’s three arms make smaller incisions than an open surgery does. The result of those tinier incisions — smaller scars, less pain and quicker recovery.
At Dale’s appointment, Hagerty takes a quick look at the scars on his belly. Hagerty and Dale’s mom, Sirena, point out how much they’ve shrunk since the surgery.
Hagerty: Three months and they're already looking really, really tiny, that's good.
So are you proud because they’re small, or proud because they look like battle wounds?
Dale Messinger: Proud because they’re small. I didn’t want big scars.
Sirena Messinger: He gloats...he's like, 'I had a robot incision!'
Dale was riding his bike within a week after the surgery. But if he had an open surgery with bigger, more painful incisions, Hagerty said it could’ve taken twice as long to recover.
“You can’t necessarily go back to the gym, you can’t go to recess, you can’t be running around playing sports,” she said. “Three little tiny incisions mean you’re not having that pain by cutting through all the layers of the belly, so you can go back to all of those activities right away.”
That quicker recovery time is one reason Beebe Healthcare is launching a robotics program in Lewes next month.
Kurt Wehberg will join the Sussex County health care system July 9 as chief of robotic surgery at its new Center for Robotic Surgery.
He says the robot will mostly be used in surgeries on chest and pelvic cavities, but the possibilities are endless.
“Once we establish a good foundation with that – and that’s probably a hundred different kind of procedures – then we’ll branch out into the [Ear Nose and Throat] and the smaller joint kind of surgeries as well,” Wehberg said.
Beebe will perform its first surgery with the robot mid-July on a patient with a disease inside of the chest.
Wehberg says as he looks forward to that, he sees surgery being completely transformed over the next decade into minimally invasive robotic procedures.
It’s a transformation he imagines all hospitals around the nation will eventually adopt.