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A Robot in the Operating Room

Less than 50 years ago, the idea of a robot was just that — an idea. Now robotic devices explore the surface of Mars, work in manufacturing facilities, and have made their way into operating rooms.

BACK TO: Northwest Health index

Although robotic laparoscopic surgery became more mainstream in recent years, specialists at Group Health medical centers have been using the system since 2004. "In the Urology Department, we find it's especially useful for operations on prostate cancer, kidney cancer, and congenital blockages in the kidneys," says Cristopher Garlitz, MD, a urologist at Group Health Capitol Hill Campus in Seattle.

Complex Procedures Done Through Tiny Incisions

"Robotic laparoscopic surgery allows us to do more complex procedures with less invasive techniques, so patients experience significantly less pain and blood loss," says Dr. Garlitz. "They need fewer transfusions, and they recover faster from surgery."

Laparoscopic surgery is the process of making small incisions — from the diameter of a dime to the diameter of a quarter — rather than a large cut to access the area that needs attention. A robotic assistance device reaches through these small openings to perform precise maneuvers directed by the surgeon.

Robotics Fine-Tune Visibility and Precision

The surgeon sits at a console a few feet away from the patient and guides three robotic arms. These long thin shafts are equipped with miniature cameras and instruments that mimic the movements of the doctor's fingers.

The doctor uses foot pedals to move the cameras, and hand controls with scissor-like instruments to direct the procedure. The physician views the surgical site in three dimensions and at 10 times normal magnification. Plus, the robotic instruments are exceptionally accurate, and they're so small that the surgeon can actually sew tiny blood vessels together.

Robotic surgery is not used for all procedures, says Dr. Garlitz. "We find that it's especially valuable when internal reconstruction is needed. It may not be the best choice for patients who are obese, or those who have extensive scar tissue."

A Glimpse Into the Future

The added precision, the three-dimensional view, and the significant magnification are just the beginning of improvements that may be coming to urology down the road, says Dr. Garlitz.

"Some academic centers are now applying images taken prior to surgery to the robotic system's real-time views. By overlaying the images, surgeons can be sure that they're removing all of a tumor." This technology may become more widely available in the future.

It may also become possible for a specific patient's full-body images to be connected to the robotic system. Physicians will be able to simulate that person's surgery before actually performing it — learning and making adjustments so they can optimize the actual procedure.

Most of Group Health's robotic laparoscopic surgery is performed at Virginia Mason Medical Center in Seattle, one of our contracted hospitals. Group Health physicians in Tacoma are also being trained to provide this sophisticated surgical procedure.

In addition to Virginia Mason, Group Health surgeons practice at Overlake Hospital Medical Center in Bellevue, St. Joseph Medical Center in Tacoma, and Providence St. Peter Hospital in Olympia. — KJ Fields