UNMC/NHS Receives Approval to Begin Performing Computer-Assisted
Chest Surgery Using da Vinci Surgical System
The University of Nebraska Medical Center and Nebraska Health System
will begin performing some chest surgeries using its computerized da Vinci
Surgical System. Earlier this month, the U.S. Food and Drug Administration
(FDA) approved the use of Intuitive Surgical, Inc.s da Vinci Surgical
System for surgical procedures performed in the chest.
Some of the chest surgeries UNMC and NHS will perform with the da Vinci
system include: mobilization of the internal mammary artery as part of
a coronary artery bypass, lung resections, tumor biopsies, and esophagus
surgery.
The clearance broadens potential surgical use of the system, providing
an advantage for patients and physicians, said Timothy Galbraith, M.D.,
UNMC/Nebraska Health System surgeon and chief of cardiothoracic surgery
and vice chairman of surgery. This FDA clearance made the system commercially
available for thoracoscopic procedures. The first clearance came last year
for laparoscopic procedures.
The da Vinci System currently is the only surgical robotic system that
has received FDA clearance for performing surgery in the United States.
UNMC/NHS surgeons performed their first robotic procedure using the
system last August on a patient who needed bowel resection surgery at NHS
University Hospital. To date, 12 clinical procedures have been performed
for various conditions.
Dr. Galbraith said compared to traditional surgery, robotic or computer-assisted
surgery, reduces patient pain, recovery and rehabilitation time. Using
the system will allow surgery with the chest closed — eliminating the
need to open or crack the breastbone or sternum.
Incisions made in between the ribs with the da Vinci system are less
than one inch compared to traditional surgery in which 10- to 12-inch incisions
are made through the breastbone.
With the da Vinci, patients potentially could be out of the hospital
in two days and back to work in one week, compared to traditional surgery
that may require four to seven days in the hospital and a six-week recovery
period, Dr. Galbraith said.
Safety and effectiveness of the da Vinci Surgical System was demonstrated
during a national, rigorously controlled clinical trial of 60 patients
in which its use was compared to conventional thoracoscopic techniques
for mobilization of the internal mammary artery as part of a coronary artery
bypass graft procedure.
The da Vinci Surgical System consists of a surgeons viewing and control
console having 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 articulating
instruments.
By integrating computer-enhanced technology with surgeons technical
skills, Intuitive believes that its system enables surgeons to perform
better surgery in a manner never before experienced. The system translates
a surgeons natural hand, wrist and finger movements on instrument controls
at the surgeons console outside the patients body into corresponding
micro-movements of the instrument tips positioned inside the patient through
small puncture incisions, or ports.
Twelve UNMC surgeons to date have been trained on the equipment including
general, transplantation, gynecologic, urologic, and cardiac surgeons.
Procedures performed to date include: bowel resection; hernia repair; ovarian
transposition; pelvic lymph node dissection; morbid obesity surgery; colon
resection; and bile duct exploration.
Last year, UNMC became the eighth U.S. medical center to obtain the
da Vinci Surgical System equipment. UNMC physicians affectionately named
the equipment “Chuck,” in honor of Charles Durham and his late wife, Margre,
who gave a major donation a few years ago to benefit three areas: arthritis,
prostate cancer and minimally invasive surgery.