Robotic thoracic surgery provides cancer patients at the Montefiore Einstein Center for Cancer Care with a minimally invasive approach to treat a range of conditions, including lung, esophageal and tracheal cancer. Robotic surgery reduces the impact of traditional surgery and gives patients another alternative with the potential for improved symptoms and a prolonged life expectancy. Cardiothoracic surgeon Robert C. Ashton, MD, and his team have been performing robotic surgery for more than a decade. Montefiore's surgeons are leading the development of this rapidly expanding and exciting field through its robust clinical trials portfolio.
During robotic thoracic surgery, our surgeons use the da Vinci® Surgical System, a minimally invasive robotic surgical system used in tens of thousands of procedures, including thoracoscopy, or surgery performed with the aid of an endoscope, a narrow tube with a viewing mirror or camera attachment.
The high-resolution, three-dimensional stereo viewer gives thoracic surgeons an immersive experience. Unlike conventional open surgery, daVinci Surgical System allows the target anatomy to appear at high magnification, in brilliant color and with natural depth of field. This enables our surgeons to dissect nerves accurately with minimal trauma and greater nerve preservation. To perform a procedure, our surgeons use the console's master controls to maneuver the four robotic arms, which securely hold the patented EndoWrist® instruments and high- magnification endoscopic camera.
EndoWrist® instruments enable surgeons to have better outcomes, when operating in the confined environments that are characteristic of minimally invasive surgery. The jointed-wrist design of the instruments exceeds the natural range of motion of the human hand, and the surgeon's hand movements are refined by motion scaling and tremor reduction.
The tools at the ends of the robot's arms range from five to eight millimeters, roughly the width of a standard pencil. Because our surgeons only need to make room for the instruments, not their fingers, the incisions used with a robot are considerably smaller than those made during traditional surgery. This surgery is beneficial to patients and reduces:
The da Vinci® Surgical System is really more of a computer-enhanced surgical tool than a true robot. Nothing is programmed into the robot. Instead, all surgeries are done in real time. This means the tools inside the patient move only when the surgeon's hands move; when the surgeon is still, the robot is still.
Our operating surgeon is stationed at a console several feet away from the patient, and a second surgeon remains at the patient's bedside throughout the procedure. The second surgeon changes instruments on the robot and is available to replace the surgical tool should the need arise.