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Geaton and JoAnn DeCesaris Cancer Center Institute Cancer Registry 2013 Annual Report

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Video assisted thorascopic surgery (VATS)

Video assisted thorascopic surgery (VATS) is one of the remarkable medical advances at AAMC. To understand just how remarkable, consider these two scenarios: thoracic surgery before and after VATS. Before VATS, to operate on organs in the chest cavity, surgeons began with an incision up to ten inches long, cutting though skin and muscle. Further access into the chest cavity required spreading the ribs, even removing a section of rib in some instances.

Trauma to bone, muscle, cartilage and other tissues, though unavoidable, was severe. A lengthy hospital stay ensued, followed by an extended period of recuperation at home. Pain management was often one of the major factors in the difficult and protracted recovery.

Smaller incisions, shorter hospital stays

After VATS, thoracic surgery is minimally invasive and radically different. A hospital stay following a VATS procedure lasts not weeks but two to five days. Patients can resume normal activities in days or weeks instead of months. And, not only has VATS transformed the surgical treatment of diseases of the chest cavity, it has changed and enhanced the way physicians diagnose those diseases.

A VATS procedure begins with two, three or sometimes four one-inch incisions. Through one of those incisions, surgeons insert a miniature camera via a narrow tube. The camera transmits magnified video images to a TV monitor. Depending on whether it is a diagnostic or surgical procedure, surgeons employ one or more other instruments while viewing the image on the monitor.

Other disorders of the chest cavity for which surgeons employ VATS technology include emphysema, interstitial lung diseases, mediastinal tumors (tumors between the lungs), fluid around the heart, or fluid around the lung.

With this advanced robotic system, AAMC is poised to be one of the first regional medical centers to offer robotic surgery across many specialties, including gynecology and general surgery.

da Vinci S Robotic Surgery

Benefits of Robotic Surgery

Robotic equipment allows the surgeon to provide patients with the most advanced procedures and improved experiences and outcomes. Like other minimally invasive procedures, the advantages of da Vinci include smaller and less invasive incisions, less pain, fewer complications, and shorter hospital stays and recovery times. Other benefits of the robotic system include:

The da Vinci Robotic System

The da Vinci system consists of four parts. First is a console where the surgeon sits to operate, viewing a 3-D image of the surgical field. From the console hand, wrist and finger movements the surgeon makes are seamlessly transmitted to the surgical instruments inside the patient.

On the monitor the InSite video Vision System processes, enhances and optimizes the images it provides for the surgeon as he or she operates.

A patient-side cart holds two kinds of robotic arms—instrument arms and an endoscopic arm—that execute the commands of the surgeon. The arms pivot in small incisions called operating ports, and surgical team members help install instruments and supervise them and the robotic arms during a procedure.

The arms are attached to EndoWrist instruments, each of which has a specific purpose like suturing, clamping or manipulating tissue.

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