Robotic-assisted surgery is an innovation that reduces patient recovery time and improves patient outcomes. The da Vinci Xi robotic system is an exciting addition to South County Health.
Dr. Joseph Brady discusses what to expect of robotic-assisted surgery and how this new technology benefits Rhode Island patients.
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General Surgery
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Learn more about Joseph Brady, MD
Joseph Brady, MD
Dr. Joe Brady is a fairly new general surgeon with South County Surgery and is one of only two surgeons performing surgical procedures with the daVinci Xi surgical system at South County Hospital. The daVinci Xi surgical system is one of only two of its kind in the state of Rhode Island and the latest and greatest in surgical technology. Dr. Brady specializes in hernia procedures but also performs many other types of general surgery.Learn more about Joseph Brady, MD
Transcription:
Bill Klaproth (Host): Robotic surgery has added an advanced tool in general surgery, and machines like the da Vinci XI are now often used as a minimally invasive option for complex surgeries. And here to talk with us about general surgery, and the da Vinci XI, is Dr. Joe Brady, a general surgeon at South County Health. Dr. Brady, thank you so much for your time today. So first off, what is the definition of general surgery?
Dr. Joseph Brady, MD (Guest): General surgery is the original surgery. All the other surgical specialties are kind of off-shoots from that, that developed over the years. General surgeons can trace themselves back to the very first surgeries that really were ever done.
General surgery nowadays consists mainly of abdominal surgery, surgery on the abdominal cavity, cancer surgery- a lot of cancer operations that are not specialized like brain surgery or bone surgery. But a lot of cancer operations are performed by general surgeons as well as oncologic surgeons.
In the simplest terms in today's world, in 2018, general surgery is surgery involving the abdominal abdomen, its contents, the abdominal wall. We're pretty much abdominal surgeons today.
Bill: So when it comes to general surgery then, how has that changed with the introduction or use of robotic assisted surgery?
Dr. Brady: So the da Vinci robot is the latest in a progression towards more and more minimally invasive techniques. In the past, we would open the abdomen, in some cases almost the entire abdomen from top to bottom and do exploratory surgery or remove various organs. Nowadays that can be done through smaller and smaller incisions, and the da Vinci robot is just the latest development in that trend towards more and more smaller incisions, more precise surgery.
Bill: So then, Dr. Brady, what are the direct main benefits of robotic assisted surgery versus traditional surgery?
Dr. Brady: I think a better question would be what are the benefits of robotic assisted surgery over traditional minimally invasive surgery, which would be laparoscopic surgery.
So the robotic surgery is still laparoscopic. It's still done using a tiny camera, and it's still done using what we call a pneumoperitoneum, which means putting air into your belly so we can operate. But the advantages- the specific advantages of the da Vinci robot are very excellent visualization. We have a 3-D high depth view that only the surgeons working in the console can see. There are other people in the room who can get the same view as the surgeon gets, but it's only a two-dimensional view. The surgeon gets a 3-D view, it can be very high magnification, it's very high resolution, and the instruments are much more versatile than traditional laparoscopic instruments. We refer to the laparoscopic instruments as straight sticks. They're pretty much scissors, and graspers, and grabbers.
The da Vinci has a whole array of specialized instruments which mimic the movements of the human wrist. If I move my hand in a circle, the instrument corresponding to that hand moves in exactly the same way. There are also specialized staplers and vessel sealers that are made just for the da Vinci robot.
Bill: So because this is minimally invasive, that means shorter recovery times in general. Is that correct?
Dr. Brady: Shorter times of stay in the hospital, shorter length of stay in the hospital, quicker return to normal activities. Yeah, basically just an improved enhanced recovery would be the biggest benefit for the patient.
Bill: So who is then a good candidate for robotic assisted surgery?
Dr. Brady: It ranges all the way- I personally don't do pediatric surgery, but the da Vinci robot has been used in pediatric cases, and it can be used in 90-year-olds if they're appropriate candidates for surgery. Any operation that can be done laparoscopically can be done robotically. It's not necessarily indicated for all operations, but certainly any one that can be done, can be done robotically.
Bill: Now you were talking about abdominal surgery earlier, so what are the most common types of surgeries you perform with the da Vinci XI surgical system?
Dr. Brady: As far as numbers, that would be cholecystectomies, that's removal of the gallbladder, and inguinal hernias. They would be the largest numbers because they're the most common operations that just about any general surgeon performs. I've moved to the point where I do almost all of my elective cholecystectomies, gallbladder removal, and almost all of my elective inguinal hernia repairs I do robotically.
But as far as what it can be used for, it can be used for foregut surgery. That would be hiatal hernia repair, it can be used for gallbladder removal, it can be used for liver resection, although I personally don't do that. It can be used for small bowel resection, I have done that. It can be used for gastric surgery, surgery on the stomach, any type of colon operation ranging from a light colectomy, sigmoid colon resection. These are all portions of your colon.
It can be used for an appendectomy, but I only use it in something that we call an interval appendectomy. That's an appendectomy that's done months after the patient has their first episode of appendicitis. So it's not a common way to take out the appendix, but it can be used for that.
It can be used to create colostomies. Any type of abdominal wall surgery. That would be hernias, ventral hernias, incisional hernias, it can be used for that. It is a very versatile tool. It really comes down to the surgeon's judgment about whether this is the right tool to use for any given operation.
Bill: So a variety of uses, that's for sure. So Dr. Brady, you're the only general surgeon at South County Hospital that performs surgical procedures using this machine. Is that right?
Dr. Brady: At this juncture, that is correct. That may change in the future, either near or far future, but yes I am currently the only general surgeon that's using the da Vinci.
Bill: Right, absolutely. Good point, at the time of this recording. And finally, Dr. Brady, people might feel like they have to make the trek into Providence or Boston to get this specialized treatment, but that's not true, right? Because they can come right to you.
Dr. Brady: Absolutely. This is the state of the art, top of the line da Vinci robot, and we have it right here at South County Hospital. I don't see any reason why- certainly not for- I think it comes down to what surgeries is the surgeon comfortable and experienced with performing, and that's always an individual decision made by the surgeon, and then we have the tool to do it right here at South County.
Bill: Well that's so good to know, Dr. Brady, and South County Hospital has proven methods and outcomes for southern Rhode Islanders, absolutely when it comes to general surgery and the da Vinci XI surgical system. Dr. Brady, thank you again for your time. For more information, visit www.SouthCountyHealth.org. That's www.SouthCountyHealth.org. This is South County Health Talks from South County Health. I'm Bill Klaproth, thanks for listening.
Bill Klaproth (Host): Robotic surgery has added an advanced tool in general surgery, and machines like the da Vinci XI are now often used as a minimally invasive option for complex surgeries. And here to talk with us about general surgery, and the da Vinci XI, is Dr. Joe Brady, a general surgeon at South County Health. Dr. Brady, thank you so much for your time today. So first off, what is the definition of general surgery?
Dr. Joseph Brady, MD (Guest): General surgery is the original surgery. All the other surgical specialties are kind of off-shoots from that, that developed over the years. General surgeons can trace themselves back to the very first surgeries that really were ever done.
General surgery nowadays consists mainly of abdominal surgery, surgery on the abdominal cavity, cancer surgery- a lot of cancer operations that are not specialized like brain surgery or bone surgery. But a lot of cancer operations are performed by general surgeons as well as oncologic surgeons.
In the simplest terms in today's world, in 2018, general surgery is surgery involving the abdominal abdomen, its contents, the abdominal wall. We're pretty much abdominal surgeons today.
Bill: So when it comes to general surgery then, how has that changed with the introduction or use of robotic assisted surgery?
Dr. Brady: So the da Vinci robot is the latest in a progression towards more and more minimally invasive techniques. In the past, we would open the abdomen, in some cases almost the entire abdomen from top to bottom and do exploratory surgery or remove various organs. Nowadays that can be done through smaller and smaller incisions, and the da Vinci robot is just the latest development in that trend towards more and more smaller incisions, more precise surgery.
Bill: So then, Dr. Brady, what are the direct main benefits of robotic assisted surgery versus traditional surgery?
Dr. Brady: I think a better question would be what are the benefits of robotic assisted surgery over traditional minimally invasive surgery, which would be laparoscopic surgery.
So the robotic surgery is still laparoscopic. It's still done using a tiny camera, and it's still done using what we call a pneumoperitoneum, which means putting air into your belly so we can operate. But the advantages- the specific advantages of the da Vinci robot are very excellent visualization. We have a 3-D high depth view that only the surgeons working in the console can see. There are other people in the room who can get the same view as the surgeon gets, but it's only a two-dimensional view. The surgeon gets a 3-D view, it can be very high magnification, it's very high resolution, and the instruments are much more versatile than traditional laparoscopic instruments. We refer to the laparoscopic instruments as straight sticks. They're pretty much scissors, and graspers, and grabbers.
The da Vinci has a whole array of specialized instruments which mimic the movements of the human wrist. If I move my hand in a circle, the instrument corresponding to that hand moves in exactly the same way. There are also specialized staplers and vessel sealers that are made just for the da Vinci robot.
Bill: So because this is minimally invasive, that means shorter recovery times in general. Is that correct?
Dr. Brady: Shorter times of stay in the hospital, shorter length of stay in the hospital, quicker return to normal activities. Yeah, basically just an improved enhanced recovery would be the biggest benefit for the patient.
Bill: So who is then a good candidate for robotic assisted surgery?
Dr. Brady: It ranges all the way- I personally don't do pediatric surgery, but the da Vinci robot has been used in pediatric cases, and it can be used in 90-year-olds if they're appropriate candidates for surgery. Any operation that can be done laparoscopically can be done robotically. It's not necessarily indicated for all operations, but certainly any one that can be done, can be done robotically.
Bill: Now you were talking about abdominal surgery earlier, so what are the most common types of surgeries you perform with the da Vinci XI surgical system?
Dr. Brady: As far as numbers, that would be cholecystectomies, that's removal of the gallbladder, and inguinal hernias. They would be the largest numbers because they're the most common operations that just about any general surgeon performs. I've moved to the point where I do almost all of my elective cholecystectomies, gallbladder removal, and almost all of my elective inguinal hernia repairs I do robotically.
But as far as what it can be used for, it can be used for foregut surgery. That would be hiatal hernia repair, it can be used for gallbladder removal, it can be used for liver resection, although I personally don't do that. It can be used for small bowel resection, I have done that. It can be used for gastric surgery, surgery on the stomach, any type of colon operation ranging from a light colectomy, sigmoid colon resection. These are all portions of your colon.
It can be used for an appendectomy, but I only use it in something that we call an interval appendectomy. That's an appendectomy that's done months after the patient has their first episode of appendicitis. So it's not a common way to take out the appendix, but it can be used for that.
It can be used to create colostomies. Any type of abdominal wall surgery. That would be hernias, ventral hernias, incisional hernias, it can be used for that. It is a very versatile tool. It really comes down to the surgeon's judgment about whether this is the right tool to use for any given operation.
Bill: So a variety of uses, that's for sure. So Dr. Brady, you're the only general surgeon at South County Hospital that performs surgical procedures using this machine. Is that right?
Dr. Brady: At this juncture, that is correct. That may change in the future, either near or far future, but yes I am currently the only general surgeon that's using the da Vinci.
Bill: Right, absolutely. Good point, at the time of this recording. And finally, Dr. Brady, people might feel like they have to make the trek into Providence or Boston to get this specialized treatment, but that's not true, right? Because they can come right to you.
Dr. Brady: Absolutely. This is the state of the art, top of the line da Vinci robot, and we have it right here at South County Hospital. I don't see any reason why- certainly not for- I think it comes down to what surgeries is the surgeon comfortable and experienced with performing, and that's always an individual decision made by the surgeon, and then we have the tool to do it right here at South County.
Bill: Well that's so good to know, Dr. Brady, and South County Hospital has proven methods and outcomes for southern Rhode Islanders, absolutely when it comes to general surgery and the da Vinci XI surgical system. Dr. Brady, thank you again for your time. For more information, visit www.SouthCountyHealth.org. That's www.SouthCountyHealth.org. This is South County Health Talks from South County Health. I'm Bill Klaproth, thanks for listening.