New robotic option in cancer surgery speeds women's healing

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By Catherine Holland By Catherine Holland
By Catherine Holland By Catherine Holland
By Catherine Holland By Catherine Holland
By Catherine Holland By Catherine Holland
By Catherine Holland By Catherine Holland

SCOTTSDALE and PEORIA, Ariz. – Two doctors at the Arizona Center for Cancer Care have joined the ranks of surgeons who use the da Vinci® surgical robot to help speed up the recovery process for women who have gynecologic cancers.

There are fewer than 30 doctors in the world who can do these new single-incision procedures. Fresh off training in California, Dr. Dennis Scribner and Dr. Ivor Benjamin, both specialists in gynecologic oncology, are numbers 27 and 28. And they are the only ones in Arizona certified to perform the single-site gynecologic operations.

Traditional surgical procedures for ovarian, uterine and cervical cancers are invasive and generally require long recovery times, which can delay the start of radiation and chemotherapy treatments. Starting those treatments as soon as possible gives patients better odds of beating their diseases.

Using the da Vinci® surgical robot, Scribner and Benjamin can remove the uterus, the cervix and small tumors through a single small incision – just an inch long -- right above the navel.

With traditional open surgery, the surgeon makes a large incision across the abdomen. When done via standard laparoscopy, the surgeon makes five small incisions.

The da Vinci® system is similar to laparoscopy, which is also minimally invasive, but, according to the company’s website, da Vinci® “enables your surgeon to operate with enhanced vision, precision, dexterity and control." With a computer that's at the surgeon’s command, da Vinci® “translates his or her hand movements into smaller, more precise movements of tiny instruments inside [the patient’s] body.”

So while the surgeon is not actually holding the surgical instruments in his or her hands, he or she is controlling them.

The big difference with the newly approved da Vinci® gynecologic procedures that Scribner and Benjamin are doing is the number of incisions – one as opposed to five.

"That's the new innovation. That's what we're pioneering now," Benjamin explained after performing the procedure for the first time last week.

While the da Vinci® surgical robot has been in use since receiving FDA approval in 2000, new procedures are being developed and applied all the time, many of them reducing the number of incisions a surgeon needs to make to get the job done.

Just last year, doctors at John C. Lincoln Hospital North Mountain started using the da Vinci® system for gallbladder removal surgery, which is one of the most common procedures in general surgery. Approved for that in December 2011, the da Vinci® procedure reduced the number of incisions from four to one.

"This is about a lot more than cosmetics — it's not just about scarless surgery," Dr. Rick Low said on the JCL website. "It's about pain. One incision is going to hurt less than four incisions, even if the four are small. Nobody can argue about that. One incision is a real improvement in pain control, and a major benefit to patients, even the ones who don't care about scars."

Gallbladder removal via standard laparoscopy generally requires a week to 10 days of recovery time. One of Low's patients, a mom of a 7-month-old baby and one of the first to undergo the da Vinci® procedure, told 3TV she was back on her feet "doing everything a mom needs to do" the day after her operation.

That accelerated recovery time is one of the things that makes single-incision operations so attractive to many patients. In the case of cancer patients, the sooner they recover from surgery, the sooner they can move on to the next phases of their treatments.

Low said in March 2012 that more single-incision procedures through the belly were on the horizon, and, as Benjamin and Scribner are demonstrating, he was right.

What da Vinci® allows surgeons to do is a matter of perspective. In a video demonstration on YouTube, a Seattle surgeon offered that perspective by using the surgical robot to make and throw a paper airplane. The slip of paper he used was barely larger than a penny.