Technology is revolutionizing the day-to-day operations of every profession, and surgery is no exception. Robots in the operating room are an ever-increasing reality.
Dr. Mark Delworth, medical director of minimally-invasive robotic surgery and system chief of surgery at TriHealth, spoke to HealthScene Ohio about the revolutionary capabilities of the robotic surgical system.
HealthScene Ohio: What is robotic surgery and how does it work?
Dr. Mark Delworth: Essentially, it is a computer-enhanced surgery. Robotic surgery is a computer interface between the surgeon and the patient that improves quality and efficiency. It allows for 3-D visualization and visual scaling. So, if I move my finger five inches, I can make the robot move five inches. If I make a motion, then the robot moves, and there is more precise control.
HSO: How did your journey with robotics start?
MD: I am a trained, certified cancer specialist. In 2002, a cardiac surgeon started testing robotic surgery. A partner of mine and I became involved in 2003 and we were what I call “early adopters” of the technology. We came up with various models to practice on in order to work out the kinks. We started off slow, but eventually, the program grew. Now TriHealth performs a high volume of robotic surgeries in Ohio.
HSO: What type of patient would be appropriate for this course of treatment?
MD: Generally, most people will qualify for robotic surgery, with exceptions if there is too much scar tissue. It also extends the ability to operate on more fragile or sick patients.
HSO: What are some common concerns with robotic surgery?
MD: Most of the concerns revolve around misinformation. Some people are under the impression that the robot does the surgery. The surgeon is completely in control of the situation. The other concern is the initial cost of the robot, as incurred by the hospital. I suspect this will come down in time.
HSO: Why is robotic surgery beneficial for the surgeon?
MD: Robotic surgery provides an instrument that allows surgeons to deliver the most precise, state-of-the-art, minimally invasive surgery to our patients. It is simply the most sophisticated surgical platform that provides favorable outcomes with the least amount of invasive side effects.
HSO: Compared to traditional surgical methods, how does robotic surgery benefit the patient?
MD: Smaller incisions are made with the use of robotic surgery. There is less pain, less blood loss, quicker recovery and shorter hospital stays for the patient. Also, it allows individuals to return to work faster. It is also more cosmetically acceptable because the incisions are smaller, so there is much less scar formation. Gall bladders, for instance, can be removed through a simple 1.5-inch incision that is hidden in the belly button – a preferable cosmetic result to large incisions with large abdominal scars. In some instances, robotic surgery provides accuracy that improves cancer-related outcomes.
HSO: Which types of procedures have been performed using robotic surgery?
MD: Virtually any procedure that is done by open technique can be done robotically. Cancer surgeries of all types – including lung, colon, kidney, bladder, uterus, ovarian, esophageal, splenic, liver and prostate cancers – can be removed. Complex and simple hernia repairs and removal of diseased gall bladders are also possible. There’s also reconstructive surgery of bowel, abdominal wall, organs such as kidneys, suspension surgeries for female pelvic prolapse and the like.
HSO: How long does a robotic surgical procedure typically take?
MD: The surgical procedure can take 30 minutes to half a day or more. The amount of time will depend on the complexity of the surgery.
HSO: Will insurance cover robotic procedures?
MD: Yes, typically insurance companies cover robotic surgery.
HSO: What opportunities could robotic surgery provide in the future?
I think robotic surgical platforms have only scratched the surface of what can be achieved. Future systems will likely include imaging, meaning the robot can direct the surgeon to the abnormality (tumor). Robotic platforms will become smaller and more portable. Also, feedback to the surgeon will become more sophisticated with the characteristics of virtual reality. Nanotechnology will likely be incorporated with imaging as well.
Michelle Jacobson is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Mark G. Delworth, MD graduated from the University of Kansas School of Medicine in 1988 and received his surgical and urology training at the University of Kentucky. Dr. Delworth completed a Fellowship in Urologic Oncology from the University of Texas MD Anderson Cancer Center. He has been certified by the American Board of Urology and is licensed in the state of Ohio. He is a member of the American Urological Association, the American Association of Clinical Urologists, the Large Urology Group Practice Association and the Cincinnati Academy of Medicine. Dr. Delworth is active at Bethesda North Hospital, holding the following positions: Secretary/Treasurer of Medical Staff; Member of the Medical Staff Executive Committee; Committee Chairman for the Patient Care Committee; Member of the Board of the TriHealth Cancer Institute; and Director of the Minimally Invasive and Robotic Surgery Program.
