MANHASSET, N.Y. -- George DeNoto, MD, chief of laparoscopic surgery at North Shore University Hospital (NSUH) in Manhasset, has carefully perfected a surgical technique on robotic colon surgery that has mystified other U.S. surgeons for years. Through the use of the da Vinci surgical robot, DeNoto has successfully performed a totally robotic sigmoid colon resection using this technique.
The procedure involves removing a portion of the colon that either contains a precancerous polyp, a cancer, or a segment of a benign disease such as colitis or diverticulitis. This is done through four tiny incisions using the da Vinci robot to help mobilize the colon attachments to the inside of the abdominal cavity, and to help dissect and divide the blood vessels that flow to that section of the colon.
Additionally, because DeNoto works in the upper and lower quadrant of the patient, it means the 1,300-pound robot must be moved and repositioned to work on each area of the body, a time-consuming chore that has discouraged many surgeons from performing totally robotic colon surgery. DeNoto and his team have this down to a science. They have managed to reposition and dock the robot in less than five minutes. The operation takes approximately 2.5 to 3.5 hours -- the same amount of time it takes to perform the surgery using the traditional laparoscopic method, and patients are usually discharged three days after their surgery.
"The use of the da Vinci robot is advantageous to the surgeon by offering a three-dimensional view and the use of articulating instruments, which allows us more precise and accurate dissection of the colon," said DeNoto, who has performed over 500 colon procedures laparoscopically in over a 12-year period. He added that while the da Vinci robot at first inspection appears to be a complex device, it actually simplifies the surgical process by providing physicians with a highly sophisticated and technologically advanced tool that helps the surgeons better perform their tasks. The robot affords surgeons a three-dimensional view, with an added 180-degree wrist movement, whereas the laparoscope provides surgeons with only a two-dimensional view while operating.
Many people have small pouches in their colons that bulge outward through weak spots -- similar to an inner tube that pokes through a weak spot in a tire. Each pouch is called a diverticulum. The pouches are called diverticula. The condition of having a number of pouches is called diverticulosis. This condition occurs in over 10 percent of Americans over the age of 40, and becomes more and more common as people grow older.
Approximately half of all people age 60 and over are diagnosed with diverticulosis -- a condition that will become increasingly common, as we enter the 60th anniversary of the beginning of the baby boom era in 1946.
When the diverticula become inflamed or infected, the condition then becomes known as diverticulitis. This occurs in approximately 10 to 25 percent of all people diagnosed with diverticulosis. Individuals with diverticulitis and diverticulosis are said to have diverticular disease.
When the diverticula become infected and can no longer be controlled by diet or antibiotics, surgery becomes necessary. This is when DeNoto's technique offers a new alternative to patients in need of surgical procedures.
North Shore University Hospital is the only hospital in New York and the first facility in the country to perform this procedure using this technique. The da Vinci robot is made by Intuitive Surgical Inc., based in Sunnyvale, Calif.
Source: North Shore University Hospital