New Research Helps Optimize Benefits of Robotic Approach
Jul 28, 2008
Clinical research at NewYork-Presbyterian Hospital/Columbia University Medical Center is helping bring the advantages of robotic surgery, including reduced pain and quicker recovery, to kidney cancer patients.
Using the latest-generation da Vinci® S Surgical System by Intuitive Surgical, surgeons operate through several small incisions in the abdomen. Surgeons then remove only the cancerous tissue from the kidney, and repair the remaining normal kidney tissue, all using robotic arms guided by video taken by a camera controlled by a separate robotic arm.
The stereoscopic view provides enhanced visibility, and the nimble robotic mechanism makes for easy cutting and suturing, according to Drs. Ketan Badani and Jaime Landman, who make up the robotic kidney surgery team at NewYork-Presbyterian/Columbia.
"With robotics, there is a much greater opportunity for complex reconstruction of the kidney than can typically be achieved with a standard laparoscopic approach," notes Dr. Badani, director of robotic urologic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of urology at Columbia University College of Physicians and Surgeons.
"This means that, hopefully, we will have an opportunity not only to reduce the need for kidney cancer patients to require a kidney transplant, but also reduce their need for dialysis later in life," adds Dr. Landman, director of minimally invasive urologic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and associate professor of urology at Columbia University College of Physicians and Surgeons.
In a recent issue of the Journal of Endourology, Dr. Badani described a new technique for port placement — the location of the small incision through which the robot operates — that maximizes range of motion for the robot's camera arm and working arm. The approach was shown to be successful in more than 50 cases, and has been adopted for use by medical centers worldwide.
Robotic surgery, most widely used for prostate cancer surgery, is beginning to be more widely available for other conditions. In addition to kidney cancer, Dr. Badani and Dr. Mitchell Benson (George F. Cahill Professor and Chairman of the Department of Urology at Columbia University College of Physicians and Surgeons and urologist-in-chief at NewYork-Presbyterian Hospital/Columbia University Medical Center), have established robotic surgery for bladder cancer, and they cite work being undertaken in pelvic floor reconstruction and repair of vaginal wall prolapse.
Columbia University Medical Center
Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu .
NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million patient visits in a year, including more than 230,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth in U.S.News & World Report's guide to "America's Best Hospitals," ranks first on New York magazine's "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital's mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.