Archive Hot Technology 2017

Don't Fear the Robot

A once-skeptical surgeon is now a solid supporter of using robotic arms to perform complex abdominal procedures.

Jeremy Heffner, MD

BIO

Jeremy Heffner, MD SURGEON CHAMPION Jeremy Heffner, MD, has been performing robotic abdominal surgeries for 3 years and has seen his case volume steadily increase.

I might be one of the last surgeons you'd expect to tout the use of robotics in abdominal surgery. My training was in what you might call maximally invasive surgery — acute and trauma-based procedures. But I've been using the robot for more than 3 years now, and have chalked up about 700 abdominal cases. If I can produce dramatically better outcomes on everything from appendectomies to complicated hernias to fundoplication, just about any surgeon should be able to do the same. Here are a few of the factors that turned a once-skeptical surgeon into a solid supporter of robotic technology.

Improved visualization. The robot's 3D camera and the optics in general are much better than what you get with traditional laparoscopy. The robot also has integrated fluorescent imaging. That means we can give patients an intravenous dye, hit a button and watch as all the bile ducts light up bright green. You see a perfect road map for surgery, which is especially important for patients who have a lot of inflammation or a lot of anatomical distortion. It's a huge safety advantage.

The camera is located on a chip at the tip of the robotic instrument arm and stays exactly where you put it, which is extremely helpful. You don't have to rely on someone else to keep the camera in place, so the need for multiple assistants is reduced. In addition, the camera doesn't drift during the procedure, so surgeons have a consistent view of the action.

Better control. The ability to precisely articulate the robot's instruments lets surgeons do more minimally invasive procedures and fewer open ones. For example, during some of the more complicated redo and incarcerated hernias, the robot lets me access areas that were simply out of reach before. In addition to controlling the 2 surgical arms of the robot, the surgeon can also control a third arm that holds or moves items, so he doesn't have to rely on an assistant.

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