Two-year-old Michael Sabados might play with a toy robot or two within the next few years, but he won’t remember that he’s already had an encounter with real robotics. Only, that experience was in the operating room, not the play room.
Michael had outpatient robotic surgery to reposition his undescended testicles, a condition that affects about 30 percent of boys born prematurely, and about 3 to 4 percent whose birth was full-term. Typically, the testes move from the abdomen to the scrotum shortly before birth. If they don’t descend on their own within 12 months, the baby will need surgery. In some cases, like Michael’s, the testes are located higher in the abdomen, requiring more complicated surgery that often needs to be staged as two separate operations.
In January, Dr. Craig Smith, a pediatric urologist with DuPage Medical Group, performed Michael’s second surgery, using Edward Hospital’s recently acquired second da Vinci Surgical System. It was funded through a $1.9 million donation from the Edward Foundation. da Vinci is the most advanced robotic technology that can be used for a range of minimally invasive procedures in gynecology, urology, and thoracic and general surgery.
Use of Edward’s first da Vinci Surgical System was so great since its debut in 2010 that the second system was purchased.
“We’ve used robotics most commonly for gynecological and urological surgeries, but colorectal surgeries and general surgeries are on the rise,” says Ellen Cleary, surgery manager at Edward Hospital. “And, we recently were approved to do ear, nose and throat procedures.”
Dr. Smith says surgeries involving areas difficult to visualize or to access are especially suited to robotic surgery.
“The da Vinci system features 3D, high definition imaging and greater precision than that of traditional laparoscopic equipment,” Smith says.
“Michael’s surgery only involved a few tiny incisions, and he was up and running around a couple of days after the surgery,” says Karen Sabados, Michael’s mom. “I couldn’t have been happier, and Dr. Smith took the time to carefully explain everything to us before and after the surgery.”
“It’s a special joy to see the little ones going home post-op day one, playful and active,” Smith says.
Smith also uses da Vinci for other urological conditions in children, such as the fairly common problem of urinary reflux. Surgery, called pyeloplasty, corrects the blockage that causes urine to back up.
Use of da Vinci is also of benefit to patients with colon and rectal conditions that require surgery.
“The location of some colorectal cancers has meant we’ve had to forego minimally invasive laparoscopy in favor of open surgery,” says Dr. David Piazza, a general surgeon with Naperville Surgical Associates who is also board certified in colon and rectal surgery. “This means larger incisions, longer recovery time and a greater chance of scarring that can cause obstructions later. But, robotics lets us do more of these surgeries laparoscopically. We can visualize the area better, and the robotic wrists and fingers give us a range of movement that human hands don’t have.”
He says one patient who had rectal cancer recently benefited from the technology.
“Without the robot, she would have had to have open surgery,” he says. “Robotics also enabled us to access 29 of her lymph nodes, rather than the 10 to 12 we would have gotten to with a traditional approach. This is an important advantage in cancer treatment.”
The precision of robotic surgery also gives colorectal patients a better chance of avoiding a colostomy, and in men, less risk of erectile dysfunction.
“It’s important to remember that the robot isn’t doing the surgery, the surgeon is,” Piazza says. “It’s just a wonderful extension of laparoscopic instruments. As a surgeon, I was amazed that it made what I was doing 10 times easier.”
For more information, visit www.edward.org/davinci. To make a donation to or for more information about the foundation, call 630-527-3954 or visit www.edward.org/foundation.
Health Aware is a weekly column submitted by Edward Hospital.