A New Dimension- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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September 8, 2000
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In This Issue:
A New Dimension
New rounds focus on human side of care
Blood Challenge Continues
ASK YOURSELF: How can I protect myself from TB?
National Respiratory Care Week
Surgical Robotics Break New Ground at BWH
On August 31, operating room #39 hosted the first procedure at Brigham and Women's Hospital performed with the da Vinci surgical system— a surgical robot manipulated remotely by the surgeon using three-dimensional images as a guide. BWH is the only hospital in New England and one of only five in the country to host and operate a surgical robot of this kind. The next major advancement in minimally invasive surgery (MIS), surgical robotics adds a third dimension of imaging to current conventional laparoscopic MIS. “This is truly a sea of change in the way we treat patients, and I don't think even now we have fully imagined the new worlds of treatment we can explore with this amazing device,” said David Brooks, MD, the surgeon who successfully completed the first surgery, a gallbladder removal. Seated at a console apart from the operating table, Brooks remotely controlled the robot using 3-D images of the surgical field inside the patient. Meanwhile, assisting surgeon Ed Whang, MD, DeLois Carson, RN and surgical technician Laura Murphy were monitoring Brooks's progress on a two-dimensional screen and changing various instruments on the robot needed for different phases of the surgery. “The da Vinci surgical system has the potential to revolutionize MIS at BWH,” said Chief of Cardiac Surgery Lawrence Cohn, MD, who originally recognized the potential benefits of this innovative system in cardiac surgery and was responsible for bringing the cutting edge da Vinci system to BWH. “Cardiac surgery and other specialties will be further improved by this system,” he added. In addition to its 3-D imaging, the da Vinci’s range of motion, allows finite movements that echo those of the surgeon's own forearm and hand. The technology is advanced even further because the surgeon's eyes are in line with his or her hands—translating the surgeon’s actual hand movements into movements of the robot's “wrists” with six degrees of freedom. All of these facets solve the limitation of two-dimensional imaging and the inability to work at angles associated with conventional MIS. “Our surgical robot will dramatically expand our ability to perform MIS and extend our ability to perform major operations through minute incisions and allows us to go to areas of the body we could never reach with regular laparoscopy,” said Michael Zinner, MD, chair of the Department of Surgery. Surgical robotics will continue to be used by Brooks in abdominal surgery and will soon be available for cardiac surgery by Cohn, Lishan Aklog, MD and John Byrne, MD, pending FDA approval. Like Brooks and his surgical team, Cohn, Aklog and Byrne, as well as cardiac surgical nurses and perfusionists have received extensive off-site training at the system's manufacturer. “For the general surgeon who already does laparoscopy, the training primarily involves minor adaptations to what we already do. For the nurses and scrub technicians, learning how to set-up and service the device is a major undertaking, which adds incredibly to the complexity of the OR. For surgeons who haven't used laparoscopy, it will be an entirely new experience,” said Brooks.