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First da Vinci surgical robot in mid-Missouri arrives at Columbia Regional Hospital

Wednesday, June 11, 2008 | 6:13 p.m. CDT; updated 11:10 a.m. CDT, Tuesday, July 22, 2008
Scott Troxel, urologist, left, and Jonathan Thomas, obstetrics and gynecology surgeon, with the da Vinci surgical robot. The robot lessens recovery time for minimally invasive surgery patients.

COLUMBIA — At a demonstration Wednesday at Columbia Regional Hospital, a tiny robotic clip grasped a rubber band about the size of those used in orthodontic braces. Slowly and precisely, the robot moved the rubber band to a different area of the viewing screen.

It might look like the machine knows exactly what it’s doing, but it takes the input of a doctor sitting at a console just a few feet away to guide the robot’s movements. The doctor manipulates hand instruments and foot pedals to activate the four robotic arms, one of which contains a camera. This camera will give a detailed, three-dimensional view of the tissues and anatomy during surgery.

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In this case, the doctor was Scott Troxel, a urologist and medical director of robotic surgery for MU Health Care. Troxel was one of the surgeons who demonstrated the da Vinci surgical robot on Wednesday at the Columbia Regional Hospital Conference Center. The robot, a $1.6 million investment by MU Health Care, arrived at the hospital Tuesday. The Board of Curators approved the purchase at its June 6 meeting.

Surgeons at Columbia Regional Hospital will be the first in mid-Missouri to use a da Vinci robot to perform minimally invasive surgery, according to an MU Health Care press release. The machine allows surgeons to perform complex cardiac, urologic, gynecologic, pediatric and general surgical procedures without actually touching the patient.

At this time, only two surgeons at the hospital are certified to perform surgeries with the machine, Troxel and Steven Dresner, a urologist and chief of staff at the hospital. The surgeons will receive full certification through the hospital after they complete their first two surgeries. Then the hospital will monitor their first 20 surgeries for quality assurance, said Matt Splett, spokesman for MU Health Care.

Troxel and Dresner will perform the hospital’s first robot-assisted prostatectomy, or removal of the prostate gland, on June 16.

“This technology is really state-of-the-art,” Troxel said. “We’re eager to get started and provide patients with this option.”

Ben Mohrmann, clinical sales representative at Intuitive Surgical, Inc., manufacturer of the da Vinci surgical system, said the da Vinci prostatectomy is quickly becoming the top treatment in the nation for prostate cancer.

“People will travel to the hospital to have (this) surgery,” Mohrmann said. “The university is in a great position in this area because they’re the first in the marketplace with the system.”

The other surgeon at the demonstration, Jonathan Thomas, assistant professor in the Department of Obstetrics, Gynecology and Women’s Health, will perform his first surgery with the robot later this month; he has a follow-up case in July. Thomas and Klaus Thaler, a general surgeon, are still completing the certification process.

Thomas is excited about the benefits that the procedure offers to patients. After a traditional hysterectomy, or removal of the uterus, patients may have a five- or six-day hospital stay. But after a minimally invasive procedure, patients will most likely be able to go home the next day, he said.

“This won’t change the way I do a hysterectomy, but it will cause the operation to be less intrusive so my patients can go back to their normal lives,” Thomas said.

Instead of a large incision, surgeons using the da Vinci system operate through several tiny holes less than 2 centimeters in length. Because of the small incisions, patients experience less blood loss, shorter hospital stays and faster recovery times. The da Vinci surgery Web site adds that in many cases, patients have better clinical outcomes than with more traditional surgery.

In addition to patient benefits, the da Vinci surgical system will be an important teaching tool at the hospital.

“It’s imperative to have (this instrument) at a teaching hospital,” Thomas said. “We need it to equip our residents with the most up-to-date technology.”

Troxel said it is important for medical students to learn with the equipment.

“As an academic center, it is our mission to train future residents and physicians,” Troxel said. “Robotic surgery is becoming a standard surgical modality that we feel is important for future surgeons to have experience with.”


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