Venita Currie (Host): Robots are dramatically changing the way doctors perform surgeries, especially in the parts of the body that are hard to reach. This type of surgery provides greater precision, flexibility, and control for surgeons to reduce the pain and speed the recovery of their patients. My guest today is Master Surgeon, Dr. Charles Yang, who is an obstetrician and gynecologist. And we are going to discuss the da Vinci XI robot at the Center of Excellence at Rancho Springs Hospital. Dr. Yang, welcome to the show.

Dr. Charles Yang: Good morning, Venita. How are you?

Host: I'm great. I'm so glad we're talking about this. You know, I think most people hear that if their surgery is being performed by a robot, that the robot's in control and actually performing the surgery. What's really happening when you have a robotic-assisted surgery?

Dr. Charles Yang: When you're doing a robotic surgery, the surgeon is actually the one that's still in control. The robot is actually just an incredibly useful tool that helps to augment or helps the surgeon perform the surgeries better.

Host: And so for the robot itself, it's really being driven by the surgeon and it's not making its own decisions. It's only through the surgeon's direction that it's moving. Is that correct?

Dr. Charles Yang: Yes, it is controlled by the surgeon 100% of the time.

Host: How do you determine if you need the assistance of a robotic surgery procedure? Is there a checklist that you go through that say, "This is the patient that needs that kind of surgery"?

Dr. Charles Yang: There is no definite set list, but the robotic surgeries are reserved for the more complex and more difficult type of surgeries. So for example, in the world of Gynecology, you wouldn't use the robotic surgery for, say, a simple tubal ligation or removing the tubes for birth control. That would be a little bit of an overkill. But for harder surgery such as a hysterectomy or removing fibroids or possibly performing surgery for pelvic prolapse, the robotic is a great tool.

Host: I heard that the robotic surgery, because it's not as invasive as traditional surgeries, that patients actually heal better and faster. And what kind of recovery can people expect?

Dr. Charles Yang: There's a great advantage when it comes to robotic surgery. In new traditional surgery before the advent of laparoscopy and now robotic surgeries, often the surgeon would have to perform a large incision on the abdomen called laparotomy. And that definitely is more painful and takes longer to heal. You have more bleeding. With traditional open surgery, often the patient has to stay two, three days in the hospital to recover.

With the laparoscopic surgery, especially robotic surgery, the patients are now going home the same day. Your traditional surgery would often have an estimated blood loss of about 200-300 cc's per case. The robotic surgery brings that down to approximately 5 to 10 cc's per case. So, that's at least a 10 to 20-fold decrease in blood loss. So, it's a great benefit to patient.

Host: So for people who might need to see you and might need this type of surgery, could you give us a list of what kind of issues you're seeing and what kind of surgeries you're performing for folks to understand what kind of services they might be able to get with you?

Dr. Charles Yang: Sure. Probably the most common surgery are the type of patients that we are able to help with are the patients that have a need for a hysterectomy. Say if they have fibroids that's causing bleeding and pain or endometriosis, things that can cause chronic pain and bleeding and discomfort to the patient, and those are conditions that significantly affects the quality of the patient's lives. So, the robotic surgery is great for that. We're also able to do pelvic prolapse surgeries with the robotic system, especially in women that are in their 60s and 70s, who after reaching menopause, the tissue has gotten a bit weaker and a lot of women do suffer from urinary incontinence and pelvic prolapse. This causes them a lot of discomfort. The robot is a great instrument to help them overcome that difficulty and greatly improve their quality of lives. So, it's really useful for that. So, any cases that involves complex pelvic surgery, the robot is a great tool to have on hand.

Host: You know, one of the things we talked about before we started the show is that you've been identified as a Center of Excellence. Can you talk about what that means?

Dr. Charles Yang: Yeah. So, there is an organization called the SRC. I think it stands for Surgical Review Committee. And they go around the country, and internationally really, to identify Centers of Excellence. In order to meet that, they look at the volume and type of surgeries, the complication rates at each of the facilities, and they decide if they meet the qualification to be considered a Center of Excellence.

And under that designation, they also look at individual physicians to see if they meet different levels of designations such as Surgeons of Excellence, and then above that, master surgeon level. And so, at Rancho Springs Hospital, we're very proud to be designated as the Center of Excellence. And also, I'm very honored to be designated as a top level of Master Surgeon in the Field of Robotic Surgery.

Host: Wow. That is really impressive. And I'm wondering, if patients are not impressed by the Center of Excellence and that you have this advanced technology to help them through their surgeries, what do you say to them to try to address their concerns and let them know that this is a safe procedure and that you're well trained and qualified to help them through it?

Dr. Charles Yang: Well, I think in my own personal dealing with patients, I always want to make sure I address them as individuals and to focus on their own individual concerns and needs. There's never one-size-fits-all in the world of Medicine. And I think it's important to establish that trust and rapport with your patient. And once they feel comfortable with you, then it's easier to explain and help and understand procedures and options that they're going to be having.

In terms of Robotic Surgery, I explained to them that it really is the best way to do laparoscopy surgery, especially in complex cases. And it allows a faster healing time, less bleeding, less pain. It allows them to go home same day in most of the cases. It allows them to recover faster, having to take less pain medicine, possibly getting back to their lives faster. So, it really is a great benefit.

And one of the fun things that I do with the real life surgery is that I'll videotape their surgery. And I'll show them afterwards and the patient always gets a big kick out of that, being able to see their own surgery and understand what happened.

Host: It sounds like you have a wonderful bedside manner. Thank you very much for talking with us today. Really appreciate it, Dr. Yang.

Dr. Charles Yang: Thank you so much for your time, Venita.

Host: You are listening to Southwest Health Talk with Southwest Healthcare System, building relationships that touch the heart. For more information, you can go to swhealthcaresystem.com. That's swhealthcaresystem.com. Physicians are independent. Practitioners who are not employees or agents of Southwest's Healthcare System. The hospital shall not be liable for actions or treatments provided by physicians. This is Venita Currie. Thanks so much for listening.