By Stan Hewlett, MD, FACS, General Surgeon
There is no other facility in the region currently using the technology that my patients are treated with at
Complex foregut, pancreatic, hepato-biliary, intestinal, colorectal, and
retroperitoneal diseases are treated with “state of the art” robotic technology
and integrated complex intra-operative imaging.
The da Vinci surgical robot helps in cases not amenable to laparoscopic techniques such as Whipple, hepatectomy, esophagectomy, and others. These patients benefit from less pain and less pain medicine, less blood loss, shorter hospital stay and quicker recovery. Single site robotic cholecystectomy leaves an invisible scar, less pain, and excellent patient satisfaction.
The Artis Zeego Robotic radiographic imaging system by Siemens, the only one currently in the state, is housed in the three million dollar futuristic ‘multi-use’ angiographic and advanced endoscopic OR suite. The Artis Zeego system utilizes Robotic fluoroscopy and intra-operative computerized axial tomography using automotive assembly line precision robotic technology. This, combined with 3-D software, allows unprecedented intra-operative imaging. It is used for angiography, ERCP, cholangioscopy, PTC and ablative techniques such as RFA. On-table, intra-operative 3-D reconstruction with real time CT or previously acquired CT/MRI overlay provides the stereo tactic targeting previously only dreamed of. The surgical applications are being expanded daily.
Fluorescence imaging using indocyanine green (ICG) angiography has applications in lymphatic, tumoral, and conduit perfusion. It is useful in liver resection, esophagectomy, bowel resection, and promises to replace second look surgery in cases of questionable bowel viability.
Access to the newest, most advanced OR’s in town must be combined with the training and experience that allows adoption of these techniques and realization of their benefits. Fellowships in Laparoscopy, Surgical Endoscopy & ERCP and over a decade of experience at Bethesda and Princeton have provided me the privilege of offering the most advanced robotic and endoscopic options to every patient, no matter how complex the disease.