Robotic surgery now common practice

March 15, 2019 GMT

HUNTINGTON — There’s no substitute for a pair of steady hands honed with tens of thousands of hours in the operating room.

But since the da Vinci surgical system was approved for use in 2000, hospitals around the world have found the skilled hands of their surgeons can now perform with more tactful grace when they’re operating the even steadier hands of a robot.

No hospital in West Virginia has explored the potential of robotic surgery more than Cabell Huntington Hospital, which has performed the highest number of robot surgeries in the state and been accredited as a Center of Excellence in Robotic Surgery — meaning its staff is also teaching other facilities to start and manage their own robotics systems.


Cabell Huntington has three da Vinci Xi machines operated by more than 20 specially trained surgeons performing robotic surgeries in six different specialties: general surgery, oncology, urology, bariatric, thoracic and gynecology.

The use of robotic surgery has increased steadily each year at Cabell Huntington. In 2016, 617 robotic surgeries were performed — nearly doubling to 1,105 surgeries by 2018, with even more slated for 2019.

Many of Cabell Huntington’s surgeons have performed more than 1,000 surgeries on their da Vinci systems.

Dr. James Jensen, a urologic oncologist and director of robotic surgery

at the hospital’s Edwards Comprehensive Cancer Center, has performed nearly 1,500 kidney, bladder and prostate cancer surgeries using the da Vinci system, and was one of the first 20 doctors in the country to adopt robotic surgery as a full-time practice.

Dr. Nadim Bou Zgheib, gynecologic oncologist at the Edwards Comprehensive Cancer Center, has performed over 1,000 robotic operations. Dr. Blaine Nease, a bariatric surgeon specializing in surgical weight control operations, recently notched his 500th procedure on the da Vinci.

During surgery, the da Vinci robot is docked over the patient and the instruments still typically enter through the abdomen, through much smaller incisions than a traditional laparotomy, which opens up the belly. The surgeon sits at a nearby control panel in the operating room where they can maneuver cameras and instrumerits with a range exceeding the human hand.

This allows surgeons to move into areas of the body with great precision and better articulate their instruments than what simply a hand can sometimes do, giving a surgeon more control over the work, explained Dr. Amanda Pauley, an OB/GYN at Cabell Huntington.


But while the term “robot” may imply a certain amount of autonomy on the machine’s part, surgeons are entirely in control of the machine at all times, controlling it like any other analog instrument with the traditional skills of surgery still very much in play.

“I think people think of the robot as performing the procedure, but the robot’s just a tool to help us perform a procedure and give patients better outcomes,” Pauley said.

“If surgeons can’t do a laparotomy, they can’t just jump on the robot and do it. You have to know how to do the procedure — there’s no help with the robot.”

One of the more common operations for robotic surgeries are hysterectomies — the removal of a woman’s uterus.

Pauley, who has performed well over 100 gynecological surgeries with the da Vinci system, said patients ultimately benefit the most from the smaller incisions, typically leading to shorter hospital stays, lower risk for complications and smaller visuals left on the body post-operation.

“Most of them go home after breakfast the next morning, and honestly most of them say they don’t even take a pain pill after that first day,” said Pauley.