Maggie McKay (Host): You may have heard of robotic surgery, but do you know how it works and what the benefits are? Let's find out with general surgeon, Dr. John Nile. Welcome to Woodlawn Health Doc Talk, a podcast from Woodlawn Hospital. I'm your host, Maggie McKay.

Thanks for being here today, Dr. Nile.

John Nile, DO: Thanks for having me.

Host: Can you please tell us a little bit about yourself?

John Nile, DO: Well, I grew up in Colorado and then from there I went to medical school in Texas. I did my residency in Michigan. After my residency, I practiced in Indianapolis for about eight years. And then in 2005, I came to Rochester and I've been here ever since. So, I've been in Rochester almost 20 years.

I've raised two daughters who both went to school and one of which still lives in the community. And I'm pretty active in the community and really enjoy Rochester and don't plan on leaving.

Host: Nice. Can you tell us a little bit about robotic surgery for people who don't have any knowledge of it.

John Nile, DO: Robotics really actually started, like many things do in medicine, you know, within the battlefield or in the military applications of medicine. They were trying to figure out a way to provide medical services for patients or injured soldiers without being the doctors or medical providers being in harm's way.

And so that's how the idea of robotics became a thing. And since then it has evolved and now, there's different types of robot systems. But, the one we have, Da Vinci, it started in 2000 and it has been, you know, slowly gaining acceptance and is actually in many areas, kind of the standard of care.

Host: Dr. Nile, what's been your experience with using robotics?

John Nile, DO: Well, my experience is relatively short in time. I didn't start with robotics until 2021 after the hospital had purchased the system. And after that, I had gone through the training and in early part of 2021, I started doing robotic surgery. Since that time, I have really enjoyed using it, especially for hernia repairs. I think that it has been a really good tool in helping me keep people's surgeries minimally invasive.

In other words, I have been able to do some complex hernia repairs laparoscopically using the robotic system when previously I had to use an open technique, which of course will increase the patient's recovery time and pain postoperatively. In other words, the robotics has helped me do these types of surgeries better.

You know, I use it for more than just hernia surgeries, but I think the hernia surgeries is where it has shown the biggest difference for me. It's also very helpful with the other surgeries such as gallbladder surgeries where it gives me some better visualization of the anatomy. I can inject dyes into the patient to help me visualize or prevent injuries.

Host: You mentioned minimally invasive surgery. What are some of the other advantages of the robot?

John Nile, DO: Well, it's kind of one in the same as what I just talked about. I think the biggest advantages that the robot has is in helping visualize the anatomy. In other words, I don't have to rely on an assistant or a human being, so to speak, to hold a camera for me. The assistants will, you know, they'll get tired or they'll move or even have to sneeze and the robot doesn't do any of those things.

And so I get a pretty consistent view of the anatomy. The other things with the advantages is that the robotic arms have more of a wrist like motion where standard laparoscopy is straight sticks, if you will, that we're using to do the surgery; the robot has a wrist like motion that you can use in the arm, which helps me with dissecting the tissues and I feel it kind of helps get the surgery done with less chance of any complications. In other words, there's more precise hand movements.

Host: What about recovery? Is that quicker?

John Nile, DO: In regards to recovery, there isn't a tremendous advantage with the robot for certain surgeries, such as gallbladder disease, in getting back to work or getting back to your normal activities. But in other surgeries, there is a huge advantage. If I can get somebody's hernia repair that would have been an open or a much bigger incision, and do it laparoscopically, using the robotic systems; they will in turn have much less post operative pain, they will have much less time off of work for many people.

Host: Could you please summarize your role of robotics at Woodlawn Hospital?

John Nile, DO: First of all, we have to realize that the robot is a tool. As with any tool, it needs to be used appropriately to be effective.

With appropriate use of the robot, we can continue to improve patient outcomes and do more and more surgeries with the robotic assistance. Robots are being used more and more all over the country. Many hospitals are getting robotic systems, but most of these hospitals are larger hospital systems.

Not too many hospitals, the size of Woodlawn, have a robotic system. So I think we're kind of ahead of the curve on that. I find that using the robot is quite helpful and it does improve patient outcomes in particular with the hernia surgeries. And as time goes on, I'm going to branch out and do more surgeries with the robot and hopefully we will bring some other surgeons on board who can also use it and improve patient outcomes as well. I should also mention that we, Woodlawn actually has two robotic systems, there's an orthopedic robotic system that Dr. Sheedy uses, which is also quite helpful in certain cases. So in other words, the use of robotics in surgery is an ongoing and ever evolving technique and I think it's going to continue to be more and more a part of surgery, not just at Woodlawn, but all over the nation.

Host: In closing, is there anything else you'd like people to know who are considering robotic surgery but maybe are hesitant?

John Nile, DO: Well, there's several things that I think of, and when I talk to patients about robotic surgery, I mention some of these things. One of the things that people get concerned about when I say robotics is, you know, is a robot doing my surgery, and that is not the case. The robot is just a tool, and as with any tool, it is utilized to help you do a task.

And that's what the robot does. The robot is a very advanced tool to help me be more effective in treating patients. Robotics is slowly becoming standard of care in many areas of practice. And I think as time goes on, we're going to see more and more robotics being used for surgery. The hospital or Woodlawn is I think, at an advantage because we have a system where many smaller hospitals don't. And I think that puts us ahead of the curve with healthcare in the area.

Host: Well, it sounds very exciting, and we thank you so much for sharing your expertise today, Doctor.

John Nile, DO: Thank you for having me.

Host: Again, that's Dr. John Nile. To find out more, please visit Woodlawn hospital.org/staff/john-nile. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Woodlawn Health DocTalk, a podcast from Woodlawn Hospital.