Swedish Robotic-Assisted Surgical Program Grows, Continues to Gain Momentum
Reported May 11, 2011
As one of the first medical centers in the Northwest to perform robotic-assisted surgery, Swedish is home to the fastest growing, most comprehensive and experienced robotic-assisted surgical program in the region. Swedish established the multidisciplinary, robotic-assisted surgical program in 2005 and has since performed more than 3,400 robotic-assisted surgeries more than any other program in the region.
Swedish-affiliated surgeons are using the robotic-assisted surgical system to perform minimally invasive urological, gynecological and thoracic surgeries for diseases such as prostate cancer, kidney cancer, uterine, cervical and ovarian cancer, lung cancer and endometriosis in complex gynecological reconstruction surgeries. Recently, Swedish expanded its robotic-assisted surgery offerings and began using it for bariatric, ear-nose-and-throat, colorectal, and general surgery cases, including colon and pancreatic cancer.
In the past year, Swedish upgraded its robotic-assisted equipment and purchased three next generation robotic-assisted surgical systems to help surgeons perform an array of minimally invasive procedures. This fall, Swedish is adding a fourth robotic-assisted surgical system to advance its pioneering use of this minimally invasive surgical technology for patients at its new hospital under construction in Issaquah.
In the hands of a skilled surgeon, the da Vinci Si HD system has several advantages over traditional surgery and were committed to bringing it to the community when possible, said James Porter, M.D., medical director of the robotic-assisted surgery program at Swedish and a prostate cancer survivor who himself underwent robotic-assisted surgery. While the robots movements are under the control of the surgeon, the computer can be adjusted so that the movements of the surgeons hands on the controllers are scaled down and translated to far smaller movements. This provides a level of precision that the unaided human hand could never achieve.
The robots surgical instruments have a high-definition camera that provides surgeons an up-close, three-dimensional view of the surgery with 10-fold magnification that permits visualization of organs and tissues in the body with more clarity than either a standard laparoscope or an open procedure.
Using state-of-the-art technology, the robotic-assisted surgical system provides a precise method to help a trained surgeon use finely controlled robotic instruments to perform minimally invasive procedures safely, while speeding patient recovery. Minimally invasive surgery is performed through dime-sized (one to two cm) incisions in contrast to the much larger incisions used in traditional, open surgery, which are often as large as six to 12 inches long. Patient benefits can include faster recovery times, shortened hospital stays, less pain and scarring, and the potential for better clinical outcomes.
Swedish Adds Virtual Training Simulator and Fluorescent Imaging Device to Robotics Program
In addition to the growing number of surgical specialties being performed with the robotic-assisted surgical systems at Swedish, many of the surgeons are on the forefront of education and research in their respective specialties. The Swedish robotics program recently became the first in the Northwest to add a new virtual-reality training simulator to help surgeons practice on the robot. The device contains a variety of exercises designed to give surgeons the opportunity to improve their proficiency with the system. Simulation in all forms is becoming an important part of the learning experience fo¬r surgical technology. By providing a controlled re-creation of critical steps in instrument control, simulation allows surgeons to hone their skills in a non-clinical environment that once required expensive models or cadavers for learning.
Experience matters when it comes to robotic-assisted surgery and were proud to say that our physicians are the most experienced in the Pacific Northwest, said Richard Bergmann, administrative director of the robotics program at Swedish. Were now setting the standard industry-wide by giving physicians a new opportunity to use our new simulator to practice and gain experience in more ways.
In addition, Swedish is the first medical provider on the West Coast to use a fluorescent imaging device to highlight tissue during a procedure. The advancement provides each surgeon with an even more precise target during surgery and offers a greatly enhanced visual field. Swedish is among a small, select group of medical providers in the United States to have this technology.
The imaging device has a specially designed camera and endoscopes that allow surgeons to capture tissue images along with surrounding blood vessels by injecting a unique fluorescent dye that is activated by infrared light. This technique gives Swedish-affiliated robotic-assisted surgeons new tools that ultimately can lead to better patient outcomes.
Swedish-Affiliated Physicians Expand Use of Robotic-Assisted Surgical Systems
An additional benefit of the robotic-assisted surgery program at Swedish is its ability to grow into new territories. Head and neck surgeon Kathleen O. Stickney, M.D., performed the first transaxillary thyroidectomy in the Northwest at Swedish/First Hill in March 2011. Essentially, a thyroid lobe removal was done via a small incision under the arm rather making an incision in the front of the neck where a tight-fitting necklace would rest. This procedure is currently being performed at only a few medical centers in the United States.
“I was released from the hospital just one day after my partial thyroidectomy,” said Lauren Selig, a patient who was treated with robotic-assisted surgery to remove a large tumor on her right thyroid at Swedish. Within a few days, I returned to my normal routine at work, and within two weeks, I was in the gym doing intense cardio workouts. It is amazing to have this procedure done with no visible scar on my neck and no side effects. I dont know why anyone would choose any other procedure if they qualify as a candidate for this robotic-assisted procedure.
Another Swedish-affiliated surgeon, Namou Kim, M.D., is now performing Trans Oral Robotic Surgery (TORS) for throat and neck cancer using the robotic-assisted surgical system. Utilizing specialized robotic laser fibers and a personal tumor map (similar to a GPS navigation system), Dr. Kim removes tumors while preserving all other vital structures inside the mouth and throat. This surgical technique is particularly useful in treating patients with tumors found at the base of the tongue, tonsil or throat. This method eliminates the disfiguring approach for many types of throat cancer and it eliminates the need, in most cases, for a tracheotomy. Following this procedure, most patients find themselves with significantly improved functions in most cases, patients swallow and speak much better than other conventional therapies, including open surgeries and chemo-radiation.
More recently, Swedish-affiliated surgeon Jedediah Kaufman, M.D., performed the first robotic-assisted, spleen-preserving distal pancreatectomy in the Pacific Northwest. These surgeries increase the likelihood of preserving a patients spleen during surgery. Pamela Paley, M.D., Chirag Shah, M.D., Dan Veljovich, M.D., Charles Drescher, M.D. and other Swedish-affiliated gynecologic oncology surgeons also recently completed the first robotic-assisted laparoscopic pelvic exenteration and robotic-assisted laparoscopic splenectomy for recurrent cancer on the West Coast. Nearing their 2,000 case mark as a group, they continue to expand the potential for advanced robotic surgery including ovarian cancer and complicated pelvic surgery.
Finally, thoracic surgeons trained in robotic-assisted surgery at Swedish are utilizing this technology to treat patients diagnosed not only with lung cancer, but also with myasthenia gravis, a neuromuscular disorder, and mediastinal tumors, a growth in the central chest cavity. Thoracic specialists at Swedish, including Brian Louie, M.D., and others were the first in the Pacific Northwest to perform a robotic-assisted lobectomy, the removal of a tumor in the lung. As a result, they are the most experienced robotic-assisted thoracic surgeons in the region and are now called upon by other surgeons and research committees from around the country to discuss their techniques and advancements.
Medical Staffs Videos Help People Understand How the Robot-Assist Surgical Device is Controlled
To demonstrate how the da Vinci robotic-assisted surgical system provides surgeons with greater surgical precision and dexterity over existing approaches, the Swedish robotic surgery team produced a series of YouTube videos to help the average person better understand how it works:
Seattle Doctor Laces Football Using da Vinci Robot
Seattle Doctor Folds and Throws Paper Airplane Using da Vinci Robot
Seattle Doctor Gives Manicure Using da Vinci Robot
For more information about each of the Swedish robotic-assisted surgical team members, visit http://www.swedish.org/Services/Robotic-Surgery or call 1-855-256-ROBO (7626) to speak with the robotics program manager.
Here is a full list of Swedish-affiliated physicians who perform robotic-assisted surgery (as of May 1, 2011):
Bariatric: Ross McMahon, M.D.
Colorectal: Amir Bastawarous, M.D.
Ear, Nose and Throat: Namou Kim, M.D.; David Moore, M.D.; Kathleen Stickney, M.D.
General: Jed Kaufman, M.D.
Gynecologic: Jessie Marrs, M.D.; Heath Miller, M.D.; Jennifer Melville, M.D.; Peggy Hutchison, M.D.; Eleanor Friele, M.D.; Kristin Austin, M.D.; Jennifer Droz, M.D.; Robert Lieppman, M.D.; Mark Lowdermilk, M.D.; Tiffany McDermott, M.D.
Gynecologic Oncology: Amy Bondurant, M.D.; Charles Drescher, M.D.; Elise Everett, M.D.; Pamela Paley, M.D.; Chirag Shah, M.D.; Dan Veljovich, M.D.
Pediatric Urology: Guy Hudson, M.D.; Michelle Ebbers, M.D.
Prostate, Kidney and Urology: Joel Lilly, M.D.; John Mullen, M.D.; Steven Han, M.D.; James Porter, M.D.
Thoracic: Ralph Aye, M.D.; Alex Farivar, M.D.; Brian Louie, M.D.; Eric Vallieres, M.D.
About Swedish
Swedish has grown over the last 100 years to become the largest, most comprehensive non-profit health provider in the Greater Seattle area with 8,500 employees, 3,000-physicians and 1,200-volunteers. It is comprised of four hospital campuses (First Hill, Cherry Hill, Ballard and Edmonds); emergency departments and ambulatory care centers in Issaquah, Redmond and Mill Creek; Swedish Visiting Nurse Services; and Swedish Medical Group a network of more than 70 primary-care and specialty clinics located throughout the Greater Puget Sound area. Swedish recently opened a new emergency department and medical office building (MOB) on its Ballard campus and will open a new MOB and hospital in the Issaquah Highlands in the summer of 2011. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiovascular care, cancer care, neuroscience, orthopedics, high-risk obstetrics, pediatric specialties, organ transplantation and clinical research. For more information, visit Swedish online at www.swedish.org, www.facebook.com/swedishmedicalcenter or www.twitter.com/swedish.
In 2007, Swedish embarked upon an ambitious $100 million fundraising campaign. Campaign investments are used to support a wide-variety of initiatives throughout the health-care system, including cancer, heart and vascular, women and children, neurosciences, and orthopedics as well as programs to support underserved populations. To date, the campaign has secured gifts totaling more than $74 million. For more information or to support the campaign, visit www.campaignforswedish.org.