The Queen's Medical Center Brings da Vinci Robotic Surgery to Hawaii

Kenric Murayama, MD, and William Yarbrough, MD, with the da Vinci "robot" with its four arms. The center most arm holds the camera, which is projecting an image on the monitor above.

Leonardo da Vinci invented what many say was the first robot, circa 1495. Five hundred years later in 2007, Leonardo's namesake has been brought to The Queen's Medical Center in the form of a robot surgeons will use to perform the most delicate, minimally invasive surgeries. Queen's is the first in Hawaii to offer this technology.

Minimally invasive surgery (MIS) is surgery performed through small rather than large incisions. Also known as laparoscopic surgery, MIS represents a trend in health care, and da Vinci robotics technology is in itself a trend in MIS. The small incisions generally result in shorter recovery times, fewer complications and reduced trauma to the patient. MIS has not been widely used for more complex procedures because fine manipulation of the rigid, hand-held instruments on tissues is more difficult than in open surgery. However, the da Vinci Surgical System enables the use of MIS techniques for complex procedures like nerve-sparing prostatectomies and heart valve repair. The da Vinci is completely controlled by a surgeon; no part of the surgery is automated. What is gained is greater precision, increased range of motion and stereoscopic vision for better depth perception.

The surgeon controls da Vinci's arms and views procedures on a separate device.

The robot has four armsone holds a 3-D camera while the other three can be fitted with shears, forceps and other surgical tools. The surgeon, who sits at a remote unit connected to the robot by cabling, can easily switch control from one arm to anotherit's like having four hands. Built in stablizers get rid of tremors for completely smooth operation.

Urologists Bill Yarbrough, MD, and Gary Peers, MD, performed the first prostatectomies at Queen's using the da Vinci. The two surgeons trained in robotics at UC Irvine. [Prostatectomy] patients can usually go home after one night vs. three nights [in the hospital], said Dr. Yarbrough. They can also get back to normal activity faster.

Small objects set up for practice manipulation of da Vinci's miniaturized surgical tools.

Complex procedures are performed through one to two centimeter incisions. He emphasized that people will now benefit from the new technology here rather than having to go to the mainland. Other benefits to da Vinci prostatectomies include less blood loss, earlier removal of foley catheters (14 days vs. seven or maybe less) and the benefit of potentially better recovery at home rather than on the mainland. The da Vinci Surgical System is at least as good as conventional surgery at sparing nerve tissue and may even be better. Overall, outcomes have been reportedly better with the system. Kenric Murayama, MD, FACS, medical director of Queen's Comprehensive Weight Management Program, will soon use da Vinci in bariatric surgery. Queen's is offering the same laparoscopic procedures as before, he said, but they will be improved and better for patients. The da Vinci Surgical System can also be used for gynecologic, thorascopic and thorascopically assisted cardiotomy and general procedures.