Brevard On Cutting Edge Of Surgical Innovation

By  //  August 13, 2013


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OUTCOMES DEPENDENT ON ROBOTIC TEAM’S TRAINING AND EXPERIENCE

BREVARD COUNTY • VIERA, FLORIDA — From cutting-edge cardiac interventions to remote digital ICU care to the latest in radiation technology for cancer care, the Space Coast medical community has taken pride in its proclivity to provide the most innovative medical and surgical care locally here in Brevard County.

ROBOTIC SURGICAL SYSTEM LESS INVASIVE, MORE PATIENT-FRIENDLY

One of the most recent and ever-evolving innovative areas of healthcare is robotic surgery. Named after the great Leonardo da Vinci, the creator of the first robot around 1495, the da Vinci surgical robotic system has become an indispensable tool in the armamentarium of some surgeons in Brevard County.

Originally designed for cardiac surgery, the robotic surgical system now has a firm foothold in urologic surgery, gynecologic surgery, lung surgery and is evolving into new areas of general surgery.

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Above, the instruments have been placed into the patient on the operating table and the surgeon is shown at the instrument-guiding controls of the da Vinci robot system, which compensates for hand tremor and sudden jerks, and provides smooth movements that aid in more precise surgery. In addition the surgical field can be magnified up to 10 times compared to traditional surgery and the human eye.

Why has the da Vinci surgical system become such a major influence in current surgery?  The reason, I believe, is the dynamic and upgradeable platform this technology employs.

The da Vinci is able to evolve into new applications seamlessly because of its strong state of the art platform that provides superior vision to the human eye, advanced precision of movement with minimally invasive instrumentation, and more range of motion than the human hand.

The robotic system compensates for hand tremor and sudden jerks, and provides smooth movements that aid in more precise surgery.  In addition the surgical field can be magnified up to 10 times compared to traditional surgery and the human eye.

Finally, as new technologies emerge in healthcare, the robotic platform has the capability to upgrade and adapt to provide an even less invasive and more patient-friendly approach to surgery characterized by less pain and more rapid recovery to normal activity.

ROBOT VALUABLE TOOL FOR SPECIALLY TRAINED GENERAL SURGEONS

I completed an advanced minimally invasive surgery fellowship specializing in advanced laparoscopic general surgery, robotic and bariatric surgery two years ago and, since then, the technology and applications for the robot have continued to evolve.

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Robotic expertise and experieince is extremely valuable in selected bariatric surgery cases, and can result in safer, more effective outcomes.

Currently, in my specialty of general surgery, the robot is very useful in foregut surgery such as Heller myotomy for achalasia, paraesophageal and hiatal hernia repair for reflux, Nissen fundoplication for gastroesophageal reflux disease (GERDS), and gall bladder removal for gallbladder problems.

Weight loss surgeries (called bariatric surgery) are done by those of us who are specially trained in bariatric surgery.  Roux-en-Y gastric bypass, gastric sleeve, and revisional bariatric surgery for weight loss can be done in selected patients with robotic assistance. Other general surgery procedures, such as ventral hernia repair, and low removal of the colon may also be done with the robot.

SAFE, EFFICIENT APPROACH TO BARIATRIC SURGERY

We are currently offering and specialize in robotic bariatric surgery at Health First New Fit Bariatrics, Brevard County’s only comprehensive weight loss surgery program that performs all of the major weight loss surgeries available today.  In addition, we have a proven track record for safety, with published results focusing on improving safety and outcomes for our patients (Tieu, K, Allison N, et al. Robotic-assisted Roux-en-Y gastric bypass: update from 2 high volume centers. Surg Obes Relat Dis 2012 ).  In this study, we performed robotic-assisted bariatric surgery on 1,100 patients with an extremely low .09% leak rate, which is unheard of in bariatric surgery. This is just one example of the safety profile the da Vinci robot can provide in the hands of a surgeon and operating team that are specifically trained in robotic bariatric surgery.

OUTCOMES DEPENDENT ON ROBOTIC TEAM’S TRAINING AND EXPERIENCE

Training and experience of both the surgeon and the operating team are integral to the safety and effectiveness of robotic surgery. At Health First’s Viera Hospital, we are continuing to expand our robotic surgery platform by expanding our team with highly trained surgeons who have met stringent criteria to use the robot in their practices.

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Dr. Ken Tieu

Dr. Aimee Tieu

Dr. Aimee Tieu

Dr. Ken Tieu and Dr. Aimee Tieu, both fellowship trained in robotic surgery in their respective fields, and Dr. Amy Raup, have recently joined the staff at Viera hospital.  Dr. Ken Tieu is a general surgeon, who specializes in advanced minimally invasive surgery, bariatric surgery and robotic surgery, and his wife, Dr. Aimee Tieu, is a fellowship trained urogynecologist, who specializes in urinary incontinence and pelvic floor disorders including pelvic organ prolapse and advanced robotic gynecologic surgery, and Dr. Raup practices robotic gynecologic surgery.

COMMITTED TO ROBOTICS TECHNOLOGIC INNOVATION

Ensuring that patients have accessibility to the most innovative robotic techniques, Health First recently acquired a new technology called the da Vinci single site surgical platform that allows the surgeon to remove the gallbladder or uterus through one small 2.5 cm incision hidden in the belly button.

gallbladder2While still early in the surgical technology spectrum, this could provide superior cosmetic results while maintaining a safe, more minimally invasive approach, less pain and quicker recovery for patients.

We have several excellent surgeons who specialize in robotic-assisted minimally invasive surgery in their respective fields.  I encourage you to review their profiles and the comprehensive list of robotic surgical procedures they offer at: www.health-first.org/robotics.

ABOUT THE AUTHOR 

Dr. Nathan Allison

Dr. Nathan Allison

Nathan Allison, MD, who is a Diplomat of the American College of Surgery and Medical Director of the Viera Hospital Bariatric Program and Viera Hospital Minimally Invasive and Robotic Surgical Services Department, received his MD degree from the University of Florida and completed his internship and residency, as well as a fellowship in minimally-invasive surgery, endoscopic surgery and robotics-assisted surgery at the University of Texas in Houston. Married and the father of two children, he could have had his choice of almost anywhere in America to practice, but chose Brevard County and joined the Health First team in the summer of 2011.


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