Have you heard about da Vinci?
When you hear about da Vinci in healthcare, rarely are we talking about the famous artist behind the Mona Lisa painting. More often than not we are talking about the incredible, yet far less artistic, robotic arm which has been a force in the medical community for years. So what is the da Vinci? Dr. Jon Heeb with Lawrence Urology Specialists said it is a remote-controlled device that is used to perform minimally invasive surgeries.
Remote-controlled? So the robot does it without the help of a surgeon? That is a very common misconception. The da Vinci is a tool, similar to what has been used since surgeries have existed, but is extremely advanced and can be programmed to assist surgeons during their surgery. It is completely operated by the surgeon, but with its advanced technology, it allows for minimally invasive surgeries with smaller incision spots and shorter recovery times.
Dr. Jon Heeb
“When people think of a robotic surgery, they often think somehow it is automatic, self-controlled or artificial intelligence,” Dr. Heeb said. “However, it is just like a scalpel controlled by the surgeon to perform tasks that otherwise can only be done through a large and much more invasive incision.”
Before the da Vinci, Dr. Heeb said many of the surgeries which they use it for were significantly more intrusive and strenuous. For example, in his clinic he will use the da Vinci to perform surgery on a kidney, often to remove a tumor. Before da Vinci, Dr. Heeb said they would have done the procedure through a large incision, maybe 5-7 inches long, and the recovery time would have been longer.
“The hospital time alone for a surgery like this without da Vinci would have been three to four days in the hospital,” he said. “Now, because of this incredible technology, we can often perform surgery and send patients home the same day. The return to activity is quicker as well. With the smaller incision, recovery can be days to weeks instead of weeks to months.”
Dr. Heeb said the number of times his patients are shocked by the minimal amount of pain they have is amazing. Each time he performs surgery with da Vinci he is impressed by how quickly they often recover and how little pain they seem to be in post-surgery.
“We use the da Vinci in Lawrence Urology Specialists for procedures involving the kidney, ureter and vaginal prolapse,” Dr. Heeb said. “The surgical arm has completely changed these types of procedures from intimidating and complex to same day, minimally invasive operations.”
Though for some surgeries may not be possible to perform with the da Vinci, many procedures can now be done with this robotic arm. Dr. Heeb said in the past, scars after surgery could be anywhere from 5-6 inches long. Now, scars can be as small as 8mm.
“Cosmetically, the da Vinci can leave patients with smaller scars,” he said. “Though in some cases the scar will need to be extended depending on the procedure, with da Vinci they always remain relatively small.”
Using the da Vinci in multiple clinics
Dr. Logan Kracht
For some procedures, the team at Lawrence Urology Specialists will collaborate with Lawrence OB-GYN Specialists (LOGS). OB-GYN physician Logan Kracht said they have seen patients in need of major surgeries and in no time, they are back to doing the things they love.
“We have had patients unable to take time off of work and because of da Vinci surgery, their time off of work for the procedure and recovery is extremely minimal,” he said. “The da Vinci is changing how we perceive surgeries. Though not all patients are candidates, for some, the healing process is astounding.”
Dr. Kracht is extremely passionate about striving to get people back to their preoperative state as soon as possible after surgery. LMH Health has access to the latest technology, meaning our surgeons can perform many minimally invasive procedures and get patients back to living their day-to-day lives sooner.
“It is so good to be able to let a patient know they can leave the same day they had their procedure,” Dr. Kracht said. “It is easier on them, their families and ultimately their body, to be able to safely recover quickly. The risk of possible complications is lower when using the da Vinci as well.”
One major surgery that Dr. Kracht performs is a hysterectomy. This surgery in the past would require two to three nights alone in the hospital. Now it can often be considered a same-day surgery for patients who qualify for the da Vinci surgery.
“Because of the da Vinci, I have extremely better dexterity and precision,” he said. “It allows me to make smaller incisions and perform a surgery that otherwise would have been much more intense just using my hands.”
The best care close to home
Dr. Blake Conklin, a surgeon with Lawrence General Surgery, said the da Vinci robotic arm bridges the gap between laparoscopic and open surgery. It gives the surgeon a three-dimensional optical view and allows the best precision possible.
“It does not matter which operation is being performed with the da Vinci system, the universal statement of shorter recovery times and less pain rings true regardless,” he said. “We have patients who undergo complex, minimally invasive robotic abdominal surgeries who can be back to relatively normal activities in less than a week. Patients are often astounded by just how short the recovery time is because their initial perception is of a much longer time interval to return to their baseline. It is not uncommon for us to perform a robotic inguinal hernia repair (hernia surgery) with the patient not requiring a single narcotic pain medication in the recovery period.”
Dr. Conklin said the da Vinci is fully operated by the surgeon at the console. This is not your average robotic movie scene where a device completely runs by itself, so there is no way for this robotic arm to go rogue. He added that when the surgeon removes themselves from the console, it completely disengages the robot so that it is incapable of performing any independent maneuvers in the absence of surgeon control.
“We are far from any artificial intelligence or complete, independent robotic surgery,” Dr. Conklin said. “I inform my patients that I completely control and perform the operation. The da Vinci robotic system is an aid to assist me in completing the surgery with the smallest incisions and most precise maneuvers possible. These small incisions result in decreased incidence of abdominal hernias over time and less scarring. I am steps away from my patients at any time and my team is not only at my side, but more importantly, standing right at the bedside while they are under anesthesia. The robotic platform allows us to perform at the pinnacle of our surgical abilities.”
Although LMH Health is and will continue to be a community hospital, it does not mean the services we offer are smaller. That misconception is simply not true. The teams at LMH Health are highly trained and specialized in their care. On any given week, the team at Lawrence General Surgery can perform ten or more robotic operations.
In 2020, with the generous assistance of LMH Health Foundation, two new, state of the art da Vinci systems were installed. Dr. Chad Tate of Lawrence General Surgery said, “These systems significantly expand our ability to offer more complex robotic surgeries. Now, surgeries that would have required a larger, 1970s era incision are completed in a minimally invasive fashion. There’s just no comparison regarding postoperative pain, return to normal activities, and the risk of abdominal hernia and scar formation. It’s thrilling to see patients do so well and recover so quickly. We’re very fortunate to perform surgery in this era with such advanced technology. It’s some of the very best of a premier medical center, offered with the convenience and comfort of our trusted LMH Health community hospital.”
Dr. Blake Conklin
“We have been blessed with very generous contributions made by the community to the LMH foundation that have allowed LMH health to purchase the latest robotic systems,” Dr. Conklin said. “This has allowed us to continue to offer the latest, cutting edge technology in the care of our patients. When we know a patient is a candidate for a minimally invasive, robotic approach, it is the technique we will recommend because of the quicker recovery and diminished pain.”
When you receive care close to home, it not only cuts travel time for appointments but can aid in a quicker, easier recovery and better outcomes. The highly-trained surgeons and advanced technology at LMH Health allow many procedures and services to be accomplished closer to where you live and play.
“We offer top-notch medical/surgical services right here in your backyard, so why travel far for your care,” Dr. Conklin stated. “The team at Lawrence General Surgery and LMH Health are here to serve our patients and bring our expertise to you with a tailored, individualized approach. The technology only continues to grow. We have witnessed so much advancement in minimally invasive surgeries which will continue as we move forward. The volume in Lawrence continue to increase and the forward progression for us here is limitless.”