When a pilot flies a fighter jet, there is a computer interface that helps refine and smooth each movement. Even still, the plane cannot be flown without the pilot.
The same can be said for robotic-assisted surgery. The robot eliminates tremors and scales the surgeon's movements, while also providing magnification and 3-D vision. But without the surgeon, the surgery cannot be performed.
"The common misconception with robotic-assisted surgery is that the robot is somehow autonomous and making decisions; however, it's simply an instrument that allows the surgeon to have greater motion," says Jonathan King, MD, a surgical oncologist in the Department of Surgery at Ronald Reagan UCLA Medical Center.
Automation with a human touch
Dr. King recently performed UCLA's first robotic-assisted pancreaticoduodenectomy, otherwise known as the Whipple procedure, the most commonly performed surgery to remove tumors in the pancreas.
"When I started at UCLA in 2015, my plan was to get this going at UCLA," Dr. King says. "But it took some time to find the right patient with respect to the pathology, the anatomy and personality — they have to be willing to take on a first."
Dr. King had not intended to make robotic-assisted surgery his focus, but during a two-year fellowship at the University of Pittsburgh Medical Center, where they have been performing robotic pancreaticoduodenectomies since 2008, he grew to understand the potential leap these types of surgeries represent. The current available robotic-assisted system, called the da Vinci Surgical System, provides all the freedom of the human wrist, while allowing surgeons to do more complicated procedures, previously impossible or difficult to perform in a minimally invasive fashion.
Goals and benefits
The goal of robotic-assisted surgery is to improve patient outcomes such as the amount of time a patient spends in the hospital, an enormous benefit for cancer patients who can then receive chemotherapy sooner. Dr. King's pancreaticoduodenectomy patient was home within four days, below the average stay for patients who underwent the same procedure but without robotic assistance.
"Short of definitive scientific evidence that shows that there is a tangible benefit, it is an exploratory endeavor, but we are excited to have the opportunity to show that there is a benefit to patients," Dr. King says. "And that's what it really comes down to — how we can best treat their disease process and improve patient outcomes."
By Emily Williams