A UNM surgeon was the first to reconstruct a pediatric patient’s dysfunctional kidney without even touching him.
Jason Wilson, associate professor of surgery and section chief of pediatric urology, used a surgical robot for the 3-year-old boy’s procedure at UNM’s Children’s Hospital this summer.
Wilson said many doctors used to think they couldn’t do surgery properly without having their hands inside the patient.
“For years, with laparoscopic surgery, what people talked about is that they didn’t feel they could do the same operation as they could if they made a big incision in a patient and they used their hands,” he said. “With the robotic surgery, you can really do just as good an operation as you can with your actual hands inside of a patient.”
Satyan Shah, director of robotic surgery, said the robot’s four arms are able to mimic the surgeon’s wrist but prevent human errors.
“Traditional surgery — you make an incision, you use instruments, you kind of open a patient up and you do the operation — this is a whole new way of operating,” he said.
Shah said the hospital had only done robotic procedures on adults since September, when they bought the $2 million surgical robot. He said the robot has performed about 150 surgeries.
Robotic arms and a high-definition camera are inserted through dime-sized incisions on the patient’s abdominal area, Shah said. The robotic camera gives surgeons a three-dimensional view inside of the body.
“The vision that you get with the robot is a magnitude greater than what you could possibly get with any other forms of surgery,” he said.
In laparoscopic surgery, the surgeon sits in a console where his thumb and index finger are inserted into Velcro straps. The finger movements and control use are then mimicked by the robot.
“Whatever you do in that console, it gets translated into movements of the robotic arms, so our hands never actually go inside the body,” who said.
Shah said the surgical instruments at the end of the arms are smaller than a human finger.
During the surgery, a second surgeon switches out the different instruments and an anesthesiologist and nurse monitor the patient.
Since children’s bodies are small, Wilson said positioning the equipment properly takes some time, “It’s very hard to work with them in that small amount of space, so the robot arms can start hitting each other, and you can’t get to a certain position that you want to,” he said.
According to “Early Experiences of Robotic Surgery in Children,” an article published in the journal Surgical Endoscopy, the robots are limited in what they can do since children-sized equipment has yet to be manufactured.
Shah said while the surgeries are harder to do with the robot, the patient still experiences the robot’s benefits.
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“Obviously, you have the small incision and those are easy to recover from as opposed to making a big incision,” he said. “When you do an operation that’s less traumatic inside the body, the patient doesn’t lose much blood, there’s less pain, less scarring, they’re able to go home earlier and get back to work earlier.”
Wilson said since the patient experiences less pain, they need a smaller amount of pain medicine.
“The number-one surgery has been prostate cancer, so people who were diagnosed with prostate cancer need their prostate removed, and we’re using the robot to remove their prostate,” he said.
Wilson said once patients understand how robotic surgery works, they often choose it over traditional surgery.
“It’s nothing to be afraid of,” he said. “You hear, ‘Robot’ and think outer space things and stuff, but it’s really not like that at all. It’s just like laparoscopic surgery, but it’s just a bit more precise.”
