This is all brand new.
It’s phenomenal; it’s changed how we’ve practiced medicine.
We now are able to offer robotic surgery in dealing with early stage into endometrial
cancer, some early stage ovarian cancers and some early stage cervical cancers. It should
be the modality of choice for people with endometrial cancer and the reason for this
is because of the significantly reduced recovery time. Patients will go home the very next
day after surgery; as opposed to if they have a laparotomy with a large midline up and down
incision, then they will spend four to six days in the hospital just recovering from
the incision. So it’s the incision that makes the big difference.
I’ve had multiple patients go home from the hospital after a robotic procedure and
not even fill their prescription for pain medication. It’s just a phenomenal difference
in that they feel so much better. Basically what it is advanced laparoscopy and what laparoscopy
is where we make multiple small incisions into the abdomen and we insert laparoscopic
instruments that we can then manipulate. Well with robotic surgery, we take those laparoscopic
instruments and attach them to a robot so that the surgeon is sitting at a console and
manipulating the robotic arms. So that the robot is not the surgeon; your surgeon is
your surgeon, just with the advanced management of computer technology. And the real advantage
over general laparoscopy with robotic surgery is that the view that the surgeon has is three-dimensional
and it’s magnified so that I can see very small blood vessels. So the blood loss with
the robotic procedure is much less than with the laparoscopic or even an open procedure
because I can cauterize tiny little capillaries before there’s any blood loss because the
visualization is so enhanced.
It’s really kind of fun, because they’re just so amazed at how well they feel. If we
do the robotic procedure in the morning, they’re eating lunch in the afternoon and ready to
go home first thing in the morning. It’s really quite phenomenal.
They come in, they get their surgery, they’re home the next day, they’re feeling great;
back to work in a couple of weeks (hopefully) and then on the road to recovery.
I would never offer this procedure if it was inferior from an oncology standpoint. We absolutely
have to make certain that we’re achieving the same outcomes, because if it’s better
for the patient to have a big incision, that’s what we’re going to do for the patient.
But we’re able to do the exact same surgery through multiple small incisions than we are
with a large incision. So it’s better for the patient all around and the oncology outcomes
(the cancer outcomes) are the same.
My hope is that all intramutual cancers with the rare exception will be robotic candidates.
It’s really kind of fun, because coming to the Nebraska Medical Center; they were
very quick to get on the bandwagon with this technology. So they’ve been doing this technology
for a very long time and we’ve now added a second robot, which has absolute newest
available technology and it has a little more mobility and allows me to get into the upper
abdomen so I can do the nodal dissections that I need to do for my particular set of
patients. So we have the technology here and we’re really excited about that.
And it’s really wonderful to be able to give this option to patients because it’s
just plain better.