Ralph H. Johnson VA HCS top 5 in DaVinci Robotics Surgery

Surgeons from the Charleston VA have maintained 5th across all VA health care systems for DaVinci surgical system procedures. This aligns with the VA’s national call-to-action to utilize more current and innovative technology, techniques, and problem-solving concepts when it comes to Veteran care. The VA’s Office of Healthcare Innovation and Learning and its Innovation Ecosystem leads this initiative.

First approved by the U.S. Food and Drug Administration in 2000, the DaVinci system represents a significant asset and toolkit in attaining more positive outcomes for Veterans at all tiers of care. Unlike traditional open surgery, which requires large incisions, or conventional laparoscopy, which relies on rigid instruments, the DaVinci system gives surgeons the ability to perform minimally invasive procedures using robotic arms guided from a console. Each arm is equipped with advanced instruments that can bend and rotate far beyond the natural range of the human wrist. A high-definition, three-dimensional camera provides magnified views of the surgical site, allowing surgeons to see tiny structures in remarkable detail.

“It’s a very exciting time to be in surgery,” said Dr. Heather Evans, Ralph H. Johnson VA HCS chief of surgery. “We now have the ability to have a lot finer control of the instruments that we’re using. The platform itself attaches to the patient and allows us to standardize our motions with improved precision. The [DaVinci] platform has been around for a long time but its application continues to expand, there are things we can do now that in the past was technically impossible before.”

Charleston VA surgeons recently performed the first-ever combined robotic-assisted radical prostatectomy and bilateral inguinal hernia repair in March of this year. This method allowed two surgeons, using robotic assistance, to each complete a separate procedure in tandem under a single anesthesia and ensured the Veteran didn’t have to go through surgery multiple times and experience longer recovery times. With the expansion of the use of robotics assisted surgery, Evans hopes to continue to provide Veterans with better outcomes, less hospital visits, and lower recovery times.

“One of the exciting things we see here with the DaVinci platform is that we have two consoles,” said Evans. “I can sit at one and have an assistant, resident, or fellow surgeon sit at the other, so they can experience the exact same motions and procedures I’m working through. For training this is perfect because I can expose residents to graduated levels of responsibility as they work through their residency and learn how to be a successful surgeon. This is really important part of Veteran care and training the future of providers.”

The DaVinci system, like many robotic support systems in health care, operates by allowing the surgeon to directly interface with the robotic apparatus. It translates a surgeon’s hand movements into micro-movements of the instruments inside the patient’s body. This setup eliminates natural hand tremors and allows for unparalleled precision. The surgeon sits at a console a few feet from the operating table, using foot pedals and hand controls to guide the robot’s arms in real time.

“With these systems we’re able to keep Veterans from having longer hospital stays because the procedures are just less invasive,” Evans said. “It has really become almost standard to use robotics in some surgeries because of the benefits it affords the patients. We’ve gone from having some patients having to be admitted for three to five days to recover after surgery to now being able to go home same day after the operation. We’re seeing our Veterans report less pain after procedures which is huge for improving quality of life.”

The VA has become one of the largest adopters of robotic-assisted surgery in the nation. Many VA hospitals are equipped with DaVinci systems, using them to treat conditions that disproportionately affect veterans, such as prostate cancer and heart disease.

According to the article, Advancements in Robotic Surgery: A Comprehensive Overview of Current Utilizations and Upcoming Frontiers in the National Library of Medicine, National Center for Biotechnology Information, robotic assisted surgery often leads to more positive outcomes due to the lessened fatigue surgeons often face when working. The article explains that robotic surgery minimizes the physical strain on surgeons. Unlike traditional open surgery, which often requires prolonged standing and holding heavy instruments, robotic surgery allows surgeons to operate comfortably from a seated position at the surgical console. This reduction in physical fatigue enables surgeons to maintain peak performance throughout lengthy procedures, ultimately enhancing patient safety and surgical outcomes.

According to the article, procedures like robotic-assisted hernia repair has become increasingly popular due to its precision and minimally invasive techniques. Robotic systems allow surgeons to perform precise mesh placement for hernia repair, reducing the

risk of recurrence. Smaller incisions, less postoperative pain, and faster recovery times are all leading to more positive outcomes for patients and propelling concepts like robotic assisted care into the mainstream and general skillset for today’s surgeons.

Evans said that even with all these advanced systems it still comes down to connecting with your patient whether behind a screen or over the operating table. These platforms are innovative tools to assist a surgeon in treating a patient, but its still the expertise of a surgeon that guides them.

“I like to tell my patients that I’m a quality-of-life surgeon,” Evans said. “I want to improve the way they feel everyday so that they can maintain as much of their ability as possible for as long as they want. It is a bit of an art to address someone’s particular needs, and these systems allow for us to understand and be out on the front in getting the best results possible.”