A little help from robotic friends

New technology allows patients to recover faster from procedures

Dr. Seth Kuwik demonstrates the Mako robotic arm-assisted technology system for hip and knee replacements in an operating room at Trumbull Regional Medical Center in Warren.

WARREN — Dr. Tara Shipman pressed her face into the hood around the 3-D, high-definition viewing screen of the console in the corner of the operating room.

“The resolution is incredible. When you’re doing surgery, it’s like you’re sitting inside a person,” said Shipman, chair of the OB-GYN department at Trumbull Regional Medical Center.

She wrapped slender fingers around the two controller toggles of the da Vinci X robotic surgical system. Her feet rested next to floor pedals.

As Shipman worked the controls, three robotic arms — resembling something like a daddy longlegs with knitting needles — moved with precision over an operating table in the middle of the room. Two of the arms hold whatever surgical tools are needed.

“This has an articulated wrist, so you can get into places that you couldn’t necessarily get into,” Shipman said.

The third arm runs a tiny camera with light, allowing the surgeon to have eyes on exactly what she needs to see.

“Before, someone else had to hold the camera,” Shipman said.

Now she has control of everything with tools built for precision. “It’s minimally invasive. They have much less pain, much less bleeding. The recovery time is a lot shorter,” Shipman said.

Alexa Hall, local marketing director for the Steward Health Care System parent company, said robotic surgery uses computer-assisted technology to aid in procedures.

“Rather than operating through large incisions, surgeons use miniaturized surgical instruments that fit through a series of small incisions to reduce scarring and recovery time,” Hall said. “Surgeons can view the surgical site using magnified 3-D HD technology, enabling them to make precise adjustments to their instruments.”

Trumbull Regional took delivery of the da Vinci X robotic surgical system in October. It’s the fourth generation of the da Vinci robots and joins the third generation da Vinci Xi that the hospital acquired three years ago.

Meanwhile, in September, Trumbull Regional became the new home of the Mako robotic-arm assisted technology for hip and knee replacements. It’s the first Mako for the Warren hospital and the only one between Cleveland and Pittsburgh, Hall said. It had been housed at Northside Regional Medical Center in Youngstown, which closed in September.

“We wanted to keep it in this area,” orthopedic surgeon Dr. Seth Kuwik said.

Kuwik said like other robotic-assisted surgeries, using a robot doesn’t mean that his job has been turned over to a machine.

“With the Mako, I’m still doing it, but the robot is assisting,” he said. “You’re doing the same approach. When you make the cuts, that’s the machine.

Before the operation, the surgeon takes a CT scan of the patient’s hip or knee, which is turned into a 3-D virtual model. That information is loaded into the Mako to map out the surgical plan. It lets the robotic arm know where to go under the doctor’s guidance.

“What it does is it allows you to make joints more reproduce-able,” Kuwik said. “It helps you balance things, make it as good as it can be.

“The difference here is that it lets you change the implants a degree or two, or change the cuts a degree or two in surgery.”

A degree or two can make worlds of difference in comfort and mobility of the joint, he said.

Trumbull Regional has been using robots for three years.

Besides better optical resolution, improvements the new da Vinci X has over the slightly older da Vinci Xi include greater flexibility in the surgical arms — they are thinner and longer and can operate in tighter spaces — and the robot can be raised higher and work at different angles to accommodate larger patients, she said.

The da Vinci primarily is used for minimally invasive surgical procedures such as colorectal, thoracic, gynecology, urology and general surgery.

Kuwik said the Mako at Trumbull Regional is capable of assisting with partial and total knee replacements and total hip replacements. Previous models could not handle full knee replacements, he said.

Robots can take a bit for veteran surgeons to get used to working.

“When we’ve set (the da Vinci robot) up at the mall (for health fairs), 6-year-olds can learn it in a minute and a half,” Shipman said. “For a 50-year-old, it takes a long time. The kids sit down and take right to it.”

People taking the robot for a test drive practiced by using the arms to pick up rubber bands. Shipman noted that in no time at all, one boy had turned it into a robot-assisted rubber band shooter.

For kids, it’s like a video game, she said. For her, “This is my baby.”