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A Cutting-Edge Approach: Robotic Surgery Now at Inova Alexandria Hospital

A Cutting-Edge Approach

Inova Alexandria Hospital recently introduced a new robotic surgery program, which will offer a wide range of surgical procedures in the areas of urologic, colorectal, general and gynecologic surgeries.

“The new robotic surgical program is a tremendous opportunity to bring cutting-edge surgical services to the Alexandria community and to all of Northern Virginia,” offers Pratik Desai, MD, Medical Director of Robotic Surgery and Urology at Inova Alexandria Hospital (IAH). “Our surgeons already have a tremendous amount of experience in the robotic realm, and we now have the opportunity to bring this expertise and advanced technology to the Alexandria community so our patients can receive advanced procedures close to home.”

Minimally invasive robotic-assisted surgery has been an important component of Inova for 16 years and now is considered to be the standard of care for many procedures in the areas of urologic, gynecologic and colorectal surgery. Because of the large number of robotic surgeries it performs, Inova offers a high level of expertise.

IAH is the first and only Inova hospital to offer the latest da Vinci robot-the Xi-featuring superior capabilities for the most complex procedures. The new system offers enhanced instrumentation at the patient’s bedside, allowing the surgeon to access the surgical site from any angle. To increase the surgeon’s dexterity, the robotic arms are shorter and thinner so there is greater range of motion. For even better visualization, a surgeon using the new Xi model has the capability of inserting a camera at every surgical port.

“Inova Alexandria Hospital has made an investment in the robot that is significant,” says Dr. Desai. “The newest version of this robot gives us better flexibility to perform minimally invasive operations.”

The Robot Advantage

Robotic-assisted surgery offers numerous advantages over traditional open surgery and conventional laparoscopic surgery.

A form of minimally invasive surgery, robotic-assisted surgery is performed through small incisions, resulting in a quicker recovery. “Clearly, robotic surgery has become the standard of care in certain areas,” says Dr. Desai. “The robot offers significant improvements in pain levels, cosmetics, invasiveness of operations and sparing healthy tissue. From almost every measurable data point there appears to be an advantage with robotics over standard minimally invasive surgery.”

The da Vinci Xi® Surgical System allows the surgeon to be fully in control throughout the operation. Seated at a remote console, the surgeon views the surgical site on a magnified, three-dimensional screen while controlling the camera, robotic arms and other equipment. An assistant, a technician and an anesthesiologist stand at the patient’s bedside. During the procedure, the surgeon controls tiny surgical instruments attached to the robotic arms.

“The big advantage is we use three-dimensional images, which enhance depth perception so you can be far more precise with your movements,” says Lawrence
Stern, MD, Medical Director of Colorectal Surgery at IAH. “Another advantage is the robot features wristed instruments that bend and rotate with great precision. So, overall, you get improved visual quality, better depth perception and extra precision.”

Robotic-assisted surgery is now considered a safe, effective approach for numerous conditions. “Our surgeons perform every major abdominal surgery, including prostate surgery, kidney tumor resection, reconstruction of the bladder, pelvic floor construction, colon resection, complex hernia repair and gynecologic procedures,” says Dr. Desai. “The biggest advantage is these procedures can be done through small laparoscopic incisions with minimal hospital stays, less blood loss and fast convalescence.”

Early Catch

Last June, when Jim Snyder, 53, an account executive for Dell, went for a routine physical exam with his primary care provider, his doctor recommended that Jim have his first colonoscopy. Jim saw Lawrence Stern, MD, Medical Director of Colorectal Surgery at Inova Alexandria Hospital, for his colonoscopy, and he’s glad he did. Dr. Stern removed two polyps, and a week later the pathology showed that one was cancerous.

“We took out the polyp in the area of the rectosigmoid colon, and that came back as an invasive adenocarcinoma,” says Dr. Stern. “It was a small cancer, but in this case the margins were insufficient, and we felt that the best option would be to have that area removed in case the lymph nodes were involved.”

Dr. Stern explained that Jim could have traditional open surgery, conventional laparoscopic surgery or robotic-assisted surgery. The latter could result in a shorter hospital stay and a faster recovery. “For me, it was crystal clear,” says Jim. “Dr. Stern had performed colorectal robotic surgery more than anyone else in northern Virginia, so I felt that was the best way to move forward. Plus, having a quick recovery was a key piece for me.”

Two days after his surgery, Jim was walking three miles a day and was back to work in a week.

Unfortunately, cancer was found in Jim’s lymph nodes during the robotic procedure, but that didn’t hold him back for long. By the time he had finished chemo in February, he was back to playing golf, going to the gym twice a week and bicycling 10 miles a day on weekends.

“Dr. Stern was very thorough and very, very good,” Jim says. “I’m so glad I met with the surgeon to do my colonoscopy, because he was able to stay with me throughout the whole process, from the colonoscopy through the surgery and then the recovery. It just made a lot of sense.”

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