Extending the Robot's Reach
Someday surgeons may use a robot to assist them in every operation. But for now, most experts agree that they're too expensive and sometimes too awkward for every procedure. Robots are proving their mettle, however, when complex reconstruction or a very delicate touch is required, as well as in tight spaces and hard-to-reach places.
Gynecologic surgeons, for example, are using robots for myomectomies to cut out uterine fibroids while leaving the uterus intact. Robots are also effective tools for removing uterine and cervical cancers since they offer nerve-sparing benefits. In a soon-to-be-published study of 100 robotically assisted hysterectomies, Paul Magtibay, a gynecologic cancer surgeon at the Mayo Clinic Hospital in Phoenix found that the method "simplifies the laparascopic approach, and operating times are generally shorter."
In addition to prostatectomies, urologists use the robot for pyeloplasties to repair ureter obstructions in children and for complex kidney cancer procedures.
The robot helps, too, with Heller myotomies, which correct a condition in which the muscle at the base of the esophagus is too tight, making swallowing difficult. Using the robot, a surgeon can cut the esophageal muscle without tearing the mucous membrane underneath. Removing the spleen, which is fed by many blood vessels, can be simpler with a robot as well, say surgeons.
Surprisingly, cardiac surgery, which experts originally expected to be a major hit for the robot, hasn't really taken off, except for a few procedures like repairing the heart's mitral valve. "The robot is still a little difficult and cumbersome to work with for most cardiac procedures," says Timothy Gardner, medical director of the Center for Heart and Vascular Health at the Christiana Care Health System in Wilmington, Del.
As the technology evolves and comfort level rises, robots will most likely go mainstream. "Now we're starting to see results in less pain and less time spent in the hospital," says Bernard Park, a thoracic surgeon at Memorial Sloan-Kettering Cancer Center in New York, who uses robots during VATS (video-assisted thoracic surgery) lobectomies to remove parts of cancerous lungs.
This story appears in the July 31, 2006 print edition of U.S. News & World Report.
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