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Tue November 13, 2012
Robots Slice Time Under The Knife: A Battlefield Breakthrough
PART 2 OF A KERA NEWS SERIES: Imagine heading into surgery. Instead of a doctor’s soothing voice, you hear the whirs and beeps of R2D2. OK, so Star Wars droids aren’t holding the scalpel, but robotic techniques are radically changing the world of medicine. And North Texas hospitals are harnessing the power of robots.
Beth Nail zips around her back yard in Allen, past the fire pit, getting ready for an evening on the terrace. It’s a respite from her physically demanding job; deep tissue massage therapy.
“On a routine chest x-ray they found what looked like an anomaly and it came back very suspicious for carcinoma of the lung,” Nail says.
Usually, lung surgeons would have to make a large incision, spread your ribs, and you’d end up spending about 10 days in the hospital.
Beth Nail didn’t want to do that, so she and her husband tracked down a specialist in robotic techniques, Dr. Kemp Kernstine at UT Southwestern.
“With the robotic surgery, they removed the right upper lobe of my lung, and I’m cured,” Nail says.
The difference? Dr. Kernstine used several keyhole incisions instead of a large, open cut, so there was less wear on her body. In fact, she only spent two nights in the hospital.
As Kernstine narrates over video of a different surgery, he makes it clear: robotics is taking us somewhere we’ve never been. The surgery he’s describing? It typically takes 3 to 4 hours. With a robot, he can be in and out in 30 minutes.
“I think there’s just a wide open future of what we’re going to be able to do,” Kernstine said. “I mean sky’s the limit, this is going to be like space exploration, it will be amazing.”
Here’s how it works: Kernstine sits down at a 4-foot-high viewing station, grabs two hand controllers, puts his feet on a pair of pedals and peers into a 3-D viewer. The patient is across the room, and the doctor controls tiny instruments inserted through small incisions.
The idea of a robot with miniature arms that can cut, clean and stitch seems born of a high tech think tank. But it was actually born on the battlefield.
“It’s the U.S. military that got this all started,” Kernstine said. “And so the idea that if there was a conflict, say, in the Middle East, that you would have a surgeon, say, in Berlin that would be operating and might be operating on patients in many different areas of the battlefield without being there physically.”
Military telesurgery didn’t work out exactly as planned, but all that research and development got robotic surgery off the ground and into wide use. Now hospitals across North Texas offer everything from liver surgery to reverse vasectomy on a machine called da Vinci. There are 150 da Vinci robots, which cost $2 million a pop, in the state of Texas.
The robotics training lab at UT Southwestern lets residents and faculty members practice everything from running sutures to precise cutting.
The robotic setup might look intimidating, but research study coordinator Debroah Hogg says it’s surprisingly easy to use.
“It automatically goes where your hand goes. It moves where you would intuitively think it would,” she said.
Dr. Kernstine says hands-on training is great, but what he wants is to make UT Southwestern a robotic training hub.
Researchers there are already working on technology that would allow doctors to add computer mapping to the mix.
“These robotic technologies now are giving us the ability to actually get into small crevices and find out where malignancy is located,” Kernstine says.
But as exciting as the field of robotics is, the doctor cautions, robot-assisted surgery shouldn’t be taken lightly. He says a poorly trained surgical team can be disastrous.
“It’s not the robot, but it’s the person or the team using the robot,” he says. “And I tell patients all the time, it’s like putting a F16 in my backyard: That’s a great plane, but not in my backyard.”
Still, when done right, robotic procedures spare patients a lot of time and a lot of pain. If Beth Nail had opted for traditional surgery, she would have spent six weeks recovering at home. With robotics, she was back to her old self two weeks after surgery.
“I got home a little before noon and I was in the bed that day, sleeping, resting,” Nail says. “The next morning, I walked into the kitchen, sat on the kitchen chair, and actually ate a yogurt and drank some coffee and I really never went back to bed.”
And for that, she can thank the robots -- and the military research that developed them.