The Cancer Institute at Alexian Brothers Hospital Network

Robotic Surgery System Expected to Make Complex Operations Easier on Patients

St. Alexius Medical Center has installed a sophisticated robotic surgical system that will enable surgeons to take a minimally invasive approach to complex operations on patients with prostate, uterine and cervical cancers.

The da Vinci® Surgical System allows surgeons to operate with narrow-shafted instruments through tiny incisions, or operating ports, instead of performing open surgery. The system is expected to reduce blood loss, pain and hospital stays for patients, according to St. Alexius surgeons Geoffery Engel, M.D., and Josh Tunca, M.D. Quicker recovery times and faster returns to normal daily activities also are possible with the system. "Robotic surgery also can reduce the risk of infection," Tunca says.

In urology, the robotic system initially will be used primarily for radical prostatectomies, in which the prostate and some surrounding tissue are removed from patients with prostate cancer, says Engel, a urologist at the Hoffman Estates, Ill., hospital.

He expects a total of four or five urologists to be authorized to perform robotic surgeries at St. Alexius. Surgical teams, including surgeons, anesthesiologists and nurses, were undergoing training in the use of the robotic system early this year.

Tunca, a gynecology cancer surgeon at St. Alexius and a clinical associate professor in the Department of Obstetrics and Gynecology at the University of Illinois, will use the robotic system to perform hysterectomies and to remove the ovaries, fallopian tubes and pelvic lymph nodes in cases involving uterine and cervical cancers.

Patients undergoing these types of robotic surgeries can return home in as little as six hours after the procedure, Tunca says. Open surgery usually requires a patient to remain in the hospital for one or two days and sometimes longer. Recovery times also are much shorter with robotic surgery, he says. Patients commonly drive and sometimes return to work the day after their surgery, compared with recovery periods of four-to-six weeks or more for open surgeries, Tunca says.

The da Vinci Surgical System includes a patient-side cart with four interactive robotic arms, which securely hold a high-resolution endoscopic camera and the system's patented EndoWrist® instruments. The instruments feature a jointed-wrist design, which exceeds the natural range of motion of the human hand. With the system, "you have 17 degrees of motion, which is more than your wrist has," Engel says.

The system also includes an ergonomic surgeon's console with master controls for the robotic arms and a magnified 3D display of the surgical field, which appears in brilliant color and with natural depth of field, giving the surgeon an excellent view of delicate organs and tissue. The master controls allow the surgeon to position his or her hands and wrists naturally relative to his or her eyes. This feature and the system's vivid vision system give da Vinci surgery the look and feel of open surgery. 

To perform a procedure, the surgeon sits comfortably at the console, views the 3D image and uses the master controls to maneuver the robotic arms and the EndoWrist instruments. The system seamlessly translates the surgeon's hand, wrist and finger movements into precise, real-time movements of the EndoWrist instruments inside the patient. The system is intuitive, so that when the surgeon moves the controls in a certain direction, the EndoWrist instruments move in the same direction, giving the surgeon natural hand-eye coordination. "The robotic arms mimic your movements in real time and can enhance them and make them more precise," Engel says. "You also can see better, and the system's technology removes any tremors."