Robotic Tools, Wielded By An Experienced Team, Can Lead To Safer Surgery.
Whipple Procedure: A Complex Surgery
The experience of the robot-assisted surgery team at Newark Beth Israel Medical Center (NBI) allows it to offer one of the most complex of all cancer surgeries: removal of part of the pancreas in a surgery called the Whipple procedure.
Named for the physician who popularized it decades ago, the Whipple procedure is used to remove cancer in the pancreas when cancer has not spread to other parts of the body. It involves removing the head of the pancreas, as well as parts of adjacent organs, during a six-to-eight-hour operation.
The pancreas is located deep in the abdomen, with many organs nearby plus major blood vessels that pump 50 percent of the body’s blood.
“In order to remove the head of the pancreas, we also have to divide the stomach, small intestine and bile duct, reconnecting everything once the tumor is out,” says David Pertsemlidis, MD, Director of NBI’s Department of General Surgery.
“These patients usually need chemotherapy after surgery, but they have to heal before they can begin it,” says Dr. Pertsemlidis. “Robot-assisted surgery can shave weeks off of their recovery time, so they can begin that treatment sooner than ever before.”
More than a decade of dedicated work with robotic tools for surgery is paying off for patients, according to Adam M. Kopelan, MD, Chairman of the Department of Surgery at Newark Beth Israel Medical Center (NBI).
“Since the mid-2000s, we’ve been using robot-assisted tools for more and more complicated surgeries,” Dr. Kopelan says. “During that time, we’ve become very familiar with how to maximize the advances of each new piece of equipment. That’s been the key to allowing us to offer robotic surgery for more and more patients.”
NBI surgical teams can offer patients robot-assisted surgery for urologic and gynecologic procedures, as well as for elective surgery for the gallbladder, colon, stomach and esophagus. They can also treat patients who require one of the most complex surgical procedures, known as the Whipple procedure, for pancreatic cancer (see “A Complex Surgery,” above).
“Most hospitals do not offer the option of robot-assisted surgery for the Whipple procedure,” Dr. Kopelan says, “but because the robot offers significant safety advantages to our patients, we’ve committed the time and resources to become expert at it. It’s a process at NBI that’s been a decade in the making.”
Why A Robot?
Advances in robot-assisted surgery tools, like the da Vinci Xi Surgical System used at NBI, are exciting for physicians. But unless you’re in the medical field, it can be hard to fully appreciate how robotic surgery works and what benefits it offers.
“Robot-assisted tools allow us to perform increasingly complicated surgeries using minimally invasive techniques,” says Dr. Kopelan. Tiny tools allow trained surgeons to perform operations without the large incisions required by traditional surgery. And that brings patients many benefits: less pain; faster recovery; shorter hospital stays; less risk for infection after surgery; and less blood loss, so less need for blood transfusions.
During the operation, the surgeon uses robotic arms that are precisely guided by highly advanced computer software. “The surgeon has 100 percent control of these computer-guided tools,” Dr. Kopelan says. “Additionally, the system gives us much more control than you can have with the human hand.”
These systems also give the surgical team a clearer view inside the body. The miniature 3D cameras provide live, highly detailed video images during surgery. The team can magnify the view up to 10 times when needed, to better see intricate blood vessels and nerves.
In addition to experienced surgeons, NBI has a dedicated staff just for robotic surgeries, including registered nurses with special training in the procedures. “During surgery, this team focuses on the equipment, including high-definition video monitors and placement of the robotic arms, so surgeons can focus on the surgery,” says David Pertsemlidis, MD, Director of NBI’s Department of General Surgery.
“Not every hospital has made this investment in robotic training, and in my experience, it makes a difference in patient care,” says Dr. Pertsemlidis.
“We have a long history of using these robots,” Dr. Kopelan says. “It’s part of our belief here that minimally invasive surgery should be the standard of care whenever possible because it’s safer for most patients.”
RWJBarnabas Health and the Frederick B. Cohen, MD, Cancer, and Blood Disorders Center at Newark Beth Israel Medical Center, in partnership with Rutgers Cancer Institute of New Jersey—the state’s only NCI-Designated Comprehensive Cancer Center provide close-to-home access to the latest treatment options. You can learn more about robotic surgery at Newark Beth Israel Medical Center here.