UNMC/NHS Complete First Surgery Using Robotic Equipment
The University of Nebraska Medical Center and the Nebraska Health System
last week successfully completed its first abdominal surgery using its
new robotic surgical equipment.
Ranjan Sudan, M.D., assistant professor of surgery, and Debra Sudan,
M.D., associate professor of surgery, were co-surgeons on the Aug. 18 bowel
resection surgery at Nebraska Health System University Hospital. It was
the first bowel resection surgery done worldwide using the da Vinci Surgical
System equipment.
Last month, UNMC announced it had become the eighth U.S. medical center
to obtain the da Vinci Surgical System equipment, developed by Intuitive
Surgical Inc. UNMC physicians affectionately named the equipment “Chuck,”
in honor of Charles Durham and his late wife, Margre, who gave a major
private donation a few years ago to benefit three areas: arthritis, prostate
cancer and minimally invasive surgery.
After extensive training, UNMC physicians scheduled their first abdominal
surgery with Wray Crabill of Ralston. Due to an inflammatory bowel, the
64-year-old had been suffering from severe diarrhea and had lost about
85 pounds since January, going from 225 pounds to 140 pounds.
Now recovering at NHS University Hospital, Crabill praised the minimally
invasive procedure. “I feel really lucky to get a hold of this machine.
It saved me a lot of misery.”
Crabill admits he was initially skeptical about being the first person
to undergo surgery with the new robotic surgical equipment, but soon changed
his mind. “The upside looked a lot better than the downside,” he said.
Overall, the minimally invasive surgical equipment allows for a faster
recovery, less surgical trauma to the patient and a three-dimensional picture
for physicians, instead of the traditional, two-dimensional laproscopic
view.
“The doctor also seemed real confident so I became more confident of
the procedure,” said Crabill, who is expected to be released as early as
Wednesday from NHS University Hospital.
The surgery went extremely well, said Dr. Ranjan Sudan. “Everything
went smoothly. There were no complications or problems and the patient
is doing very well. The surgery took a little longer than usual, but only
because it was the first time.”
During the six-hour surgery, doctors made five incisions — the longest
being 1.5 centimeters in diameter — to remove about three feet of Crabill’s
small and large intestines and appendix.
“I’m very grateful for the university’s support of the surgical department
and the Durham family for having the vision to look for this type of technology
for the medical center,” said Dr. Debra Sudan. “It truly will change the
way we do surgery over time.”
Both Sudans recognized other members of the surgical team including
staff nurses Missy O’Brien and Kathy Wonder and chief perfusionist Lance
Fristoe. They also acknowledged Crabill for his willingness to be the first
robotic surgery patient and Byers Shaw, M.D., chairman of the surgery department,
for supporting the development of the technology at UNMC/NHS.
The da Vinci Surgical System consists of a surgeon’s viewing/control
console that has an integrated, high performance 3-D vision system; a patient-side
cart consisting of three robotic arms that position and precisely maneuver
endoscopic instruments and an endoscope; and a variety of surgical instruments.
The system translates the surgeon’s hand, wrist and finger movements
into corresponding movements of the instrument tips positioned inside the
patient. Using the robot, the surgeon needs to make only tiny incisions,
or ports, in the patient, instead of a longer incision needed for conventional
surgeries.
Dr. Ranjan Sudan said stapling procedures were done laproscopically
during the Crabill operation because the da Vinci currently doesn’t have
stapling instruments. The company is in the process of licensing the technology.
Without the da Vinci System, Crabill likely would have faced open surgery
which would have resulted in a much longer recovery time, including no
heavy lifting for six weeks, and a six-inch long scar, Dr. Ranjan Sudan
said. It also may have presented other complications because the patient
has emphysema.
Instead, Crabill was walking the hospital hallways only one day after
surgery. He also had renewed physical strength. “I think it’s a miracle
if I’m out of here within a week after major surgery. When I checked in
(Aug. 18) I was very weak and looked like a concentration camp prisoner.”
Crabill spent 15 years working in a San Francisco hospital, first in
dietetics then in purchasing. About a decade ago, he returned to Nebraska
after his parents died. He is retired and lives on Social Security.
Said Crabill, when asked if he would again choose robotic surgery: “I
would recommend it, absolutely.”