PAtient Profile Continued from page 7
Debra Carse, 47, of Upper St. Clair, is a married mother of two and a registered nurse. As a nurse, she was aware of robotic-assisted surgery and knew that St. Clair Hospital was using a da Vinci system. She also knew Dr. McGranahan well, as a colleague and as her gynecologist. When Dr. McGranahan suggested that she have a robotic-assisted, hysterectomy to treat abnormal uterine bleeding that had persisted for two years, Debra had no doubt that this was the right option for her. “Dr. McGranahan was excited about
Pioneering technology
“
the most dIffIcult aspect of thIs surgery Is that you feel so good, you forget that you had surgery.
Art, Science and Science Fiction Merge in the da Vinci Surgical System
”
DEBRA CARSE
Robotic-assisted surgery is associated with a lower rate of complications and reduced
robotic-assisted surgery for gynecology,
length of stay. Patients have less post operative
and everything went exactly as she told me
pain, and subsequently less need for narcotic
it would. Dr. Brown assisted her, so I had
pain medication, and they experience far less
the benefit of having both of them there.
bleeding. They require minimal post-operative
Post-op, I had some discomfort from bloating,
nursing care. Instead of 6- to 12-inch abdominal
computer era, with a bit of science fiction
but my pain was so minimal that I only took
incisions and scarring, they have five tiny
in the mix, too.
Motrin.” Debra has exceptional appreciation
incisions that are more like punctures. Without
he da Vinci Robotic Surgical System
T
used primarily to mobilize hazardous
on the robotic technologies. The goal was
is the result of a convergence of
materials in unsafe environments, much
to take these innovative concepts and turn
powerful forces: the science of medicine,
like the bomb-detecting robots that police
them into a marketable medical device that
the art of surgery and the technology of the
use today.
allowed surgeons to operate intuitively.
In the 1980s, advances in electronics
In conventional laparoscopic surgery, the
and computer technology further propelled
surgeon moves the instrument handles in
the development of robotics. At the same
the direction that is opposite the way she
large wounds, patients are less likely to develop
device originates in the Italian Renaissance,
time, surgeons were developing minimally
or he actually wishes to go — an approach
an infection. Robotic-assisted surgery means
in the innovative mind of Leonardo da Vinci.
invasive surgery techniques and in 1987,
that surgeons describe as counter-intuitive.
robotic-assisted laparoscopy.
a shorter hospital admission ― usually one
da Vinci was undeniably a genius: a painter,
French surgeon Phillippe Mouret performed
Within four years, in 1999, the first
“Without an abdominal incision,
night as opposed to three or four following
sculptor, musician, architect, engineer,
the first laparoscopic gall bladder removal.
da Vinci system was introduced and cleared
you’re able to move easily —
open abdominal surgery ― and a faster,
inventor and mathematician. He created
Following that, there was explosive growth
by the FDA for laparoscopic surgery.
arguably the most finely detailed and
in laparoscopic technology and methods
easier recovery. For patients, that’s the real
anatomically accurate drawings of the
for simple surgical procedures.
miracle of robotic-assisted surgery.
human body ever produced. da Vinci also
The prototype for the da Vinci robotic
for the dramatic contrast between recovery from open abdominal surgery and
to stand and sit, to get in and out of bed, to shower and
The story of this breakthrough surgical
Intuitive Surgical, which is now the global leader in robotic-assisted, minimally invasive surgical technology, chose to call the
even to breathe normally.
For Audrey Smith, a mother of three and
loved machines and mechanics. He loved
surgical system was created in the late 80s
robotic surgical system the “da Vinci” in
All you have are five little
management consultant who lives in Mount
to study and improve existing machines,
in an effort to improve military surgical
honor of the artist who created the first robot.
‘poke holes,’ where the
Lebanon, the decision to have robotic-assisted
and designed everything from harmonicas
capabilities for the U.S. Army. The Defense
With his apparently limitless capabilities
instruments were inserted.
surgery was more complicated. Smith was
to military tanks. In 1495, he developed
Advanced Research Projects Agency
and creativity, da Vinci blended art and
planning a business trip to China when
the world’s first robot, a medieval knight
(DARPA) funded research to test the
science in a singular way. His legacy has
Dr. McGranahan, her OB-GYN, informed her that
in armor that could sit, stand, walk and
feasibility of a remote surgery program for
endured for centuries and he continues to
she had large fibroid tumors that necessitated
turn its head.
use in the front lines of battle. The idea was
inspire futuristic thinkers, including those
to substitute robots for human medics and
who developed the robotic surgical system
another creative thinker, Robert Heinlein,
surgeons, to keep them out of harm’s way.
that is transforming many surgical specialties.
wrote a science fiction novel called Waldo,
The robotic medic concept never flourished,
about a man too physically weak to care for
but the DARPA research advanced the
himself. He gained some independence by
development of surgical robotics. Another
Because there is so much less manipulation of the internal organs, you experience less pain
a hysterectomy. “I was quite anxious,” Smith
and swelling. The most
recalls. “I had had previous abdominal surgeries
difficult aspect of this
and I knew what was involved; I was laid up for
More than four centuries later, in 1942,
surgery is that you feel
six weeks with those surgeries and had a lot of
so good, you forget that you had
pain. I had this trip to China scheduled for four
using a device that enabled him to manipulate
influence was the NASA-funded work of
surgery. When I lifted things, I felt
weeks after the surgery, which could not be
a mechanical arm. Inspired by the book,
scientists at the Jet Propulsion Laboratory
a pulling sensation that was like a
canceled. I was worried; would I be recovered
inventors began designing remote
in Pasadena, Calif.
reminder — ‘oh, yeah, I just had a
enough to go? Plus, I was dealing with a lot of
manipulators, called Waldoes, and by 1950,
hysterectomy, better slow down.’”
emotions about having a hysterectomy.”
these early robots were a reality. They were
Intuitive Surgical was founded in 1995 in Sunnyvale, Calif. and secured licenses
Continued on page 10 Debra Carse 8 I HouseCall I Volume V Issue 1
Volume V Issue 1 I HouseCall I 9