February 15, 2019 by John Fernandez and Tanya Racoobian
(VIDEO) Surgeons Present Latest Robotic Surgery Techniques in Miami Beach
A patient under anesthesia lies on a table in an operating room, as a surgeon leads a team of nurses and technicians to guide a four-armed machine that will be used in the surgery over the table and the patient. After making a few small incisions to begin the operation, the surgeon equips the device’s arms with surgical instruments and places them inside the patient’s body. He then sits at a console a few feet away from the patient to perform the surgery using his hands to remotely control the arms of the robot. This same scenario – one reminiscent of science-fiction plots of yesteryear – plays out repeatedly each day at several Baptist Health hospitals.
(VIDEO UPDATE: Listen to Ricardo Estape, M.D., explain some of the advanced procedures discussed at this year’s meeting.)
It’s called robotic surgery, and Baptist Health surgeons have emerged as worldwide leaders in this minimally invasive approach to accessing and repairing diseased areas inside the human body. In fact, more than 100 surgeons, representing six specialties, treat patients with robotic surgery daily using 12 robots located at South Miami Hospital, Baptist Hospital, Doctors Hospital and West Kendall Baptist Hospital.
This wide reach, along with the more than 10 years of experience using robot-assisted techniques, positions Baptist Health’s surgeons as renowned experts and pioneers in their fields who draw other surgeons, nurses and technicians to Miami Beach to learn from them at the Miami Robotics Symposium.
“This is our fourth Symposium, and planning for each one shows us all how far we have come as surgeons and how much robotic surgery has improved for patients and surgeons over the last decade,” said Ricardo Estape, M.D., a gynecologic cancer surgeon at Baptist Health’s Center for Robotic Surgery.
Sharing Information Benefits Patients
While doctors and other healthcare professionals learn about various aspects of robotic surgery at the Symposium, patients reap the benefits of the better surgical techniques, lessons learned and patient experiences that are shared among attendees.
Dr. Estape, who pioneered robotic surgery at Baptist Health by performing the first case at South Miami Hospital in 2006, has watched and participated in numerous advances to benefit patients’ recovery and long-term prognoses. He and his fellow gynecologic surgeons will share their expertise in treating cancer and benign diseases and conditions of the female reproductive system using robotic surgery to perform the following:
- Single-site hysterectomies – Using one incision through the belly button to remove the uterus, surgeons minimize trauma to the abdominal tissue and improve recovery time, while also minimizing scarring for patients.
- Sentinel lymph node detection and removal – Using fluorescent dye to detect the first lymph node that is, or could be, harboring cancer cells as they try to spread to other parts of the body, helps surgeons, like John Diaz, M.D., better visualize this sentinel lymph node and remove it for testing. Sparing other lymph nodes that may not be affected reduces the chance of a long recovery and delay of life-saving chemotherapy. Dr. Diaz recently presented findings about this technique at a national meeting of gynecologic oncologists.
- Pelvic reconstruction – Surgeons now use the robot to repair defects in the pelvis that can lead to urinary incontinence, pelvic organ prolapse, infertility and miscarriages with quicker recoveries and improved long-term quality of life for these patients.
- Fibroid removal – Surgeons at South Miami Hospital’s Fibroid Center have used the robot to perform myomectomies, or the removal of fibroids, which are benign tumors that can cause severe abdominal pain, irregular bleeding and infertility. With recent news of how fibroids can mimic, in appearance, a deadly form of uterine cancer known as leiomyosarcoma, the Symposium will feature a discussion about how surgeons are minimizing the chances of spreading this cancer in low-risk patients.
A common surgery, hernia repair, currently takes on many forms, and Baptist Health Medical Group general surgeons Anthony Gonzalez, M.D. and Rupa Seetharamaiah, M.D., have had proven results using robotic surgery to repair ventral hernias, which occur in the abdomen. These surgeons will share at the Symposium how a robotic approach can achieve the same treatment results as traditional techniques where the abdomen is opened, but with minimal trauma to the abdominal wall, leading to a quicker recovery and less scar tissue. Not all ventral hernias can be repaired robotically, they say, but a majority of them can. The surgeons published their findings in the Journal of Medical Robotics and Computer Assisted Surgery in September 2014.
The Symposium also will include sessions highlighting the work of Dr. Gonzalez, Dr. Seetharamaiah and their colleague Jorge Rabaza, M.D., who perform weight-loss – or bariatric – surgery using the robotic platform. They will share their techniques, positive experiences and accounts of patients who have undergone various types of robot-assisted bariatric surgery and have gone on to lose significant amounts of weight with few-to-no complications. They will also review advances in instrumentation and tools, such as surgical staplers and fluorescence imaging, that help improve the safety and effectiveness of the robotic procedures they perform, limiting complications and a need for patients to return to the operating room for follow-up surgery.
Mark Dylewski, M.D., a thoracic cancer surgeon at Miami Cancer Institute and medical director of thoracic and robotic surgery for Baptist Health Medical Group, will lead discussions about surgically treating lung disease, including lung cancer, while his partner John DeRosimo, M.D., will present interesting cases of esophageal conditions that were improved with robotic surgery. Dr. Dylewski also will perform a live robotic surgery for Symposium attendees to learn the latest techniques in robot-assisted thoracic surgery.
“We’re always excited to share our experiences with our colleagues from around the world,” Dr. Estape said. “Our work in robotic surgery, which has been documented, proven and shared over our 10-year history, not only helps these colleagues perform better, safer and more efficient surgery, but we’re paving the way to improve surgical results for our patients. That’s a win-win situation that we’re proud to help create.”