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Advantages of Robot-Assisted Surgery

Robotic surgery is a minimally invasive operation that uses robotic arms which serve as a surgeon's hands and eyes. Roswell Park is a leader in training surgeons from around the world in robotic surgery. Our surgeons have performed more than 4,000 operations since 2004 using the da Vinci Surgical System®.

In this segment, Khurshid Guru, MD., Chair, Department of Urology; Director, Robotic Surgery at Roswell Park Comprehensive Cancer Center, discusses the many benefits of robotic surgery.
Advantages of Robot-Assisted Surgery
Featured Speaker:
Khurshid Guru, MD
Khurshid A. Guru, MD, was appointed Director of Robotic Surgery at Roswell Park Comprehensive Cancer Center in October 2005. Dr. Guru completed his residency training in Urologic Surgery (2005) and a Robotic Surgery Fellowship (2004) at the Vattikuti Urology Institute, Henry Ford Health System, MI.

Learn more about Khurshid Guru, MD
Transcription:
Advantages of Robot-Assisted Surgery

Bill Klaproth (Host): Robotic surgery is a minimally invasive operation that uses robotic arms, which serve as a surgeon’s hands and eyes. Here to tell us more is Dr. Khurshid Guru, Chair, Department of Urology, and the Director of Robotic Surgery at Roswell Park Comprehensive Cancer Center. Dr. Guru, thank you for your time. Can you explain more about robotics and the increasing role that it is playing in surgery?

Dr. Khurshid Guru (Guest): Thanks for having this, Bill. Yes, it is definitely playing a role. The last decade has seen an evolution of this technology. What it means for you, me, and the patient is that it’s a miniaturized form of help in the operating room where you have miniaturized hands inside the body without making the big incisions. The view of the field is magnified. Even though your hands are miniaturized, but your view is magnified, so it makes your surgical field more friendlier, and you can see things way better -- especially for cancers which are in areas where the space is limited like the pelvis for gynecology, urology, removing bladder, prostate, uterus, kidneys – these operations, it’s really a very good tool.

Bill: So it really allows you to be more effective during the surgery process?

Dr. Guru: Yes, and that translates into quicker recover in terms of smaller incisions, less blood loss, quicker healing and getting back to day to day activity. Obviously, you have to be an expert, and you have to know how to use the equipment and the machine well, so that has to be taken into consideration. After that’s taken into consideration and you have an expert running the machine, you kind of have a good hand with better vision, and in smaller spaces, they can operate well.

Bill: Those are very important benefits, for sure. What types of patients are eligible for robotic surgery?

Dr. Guru: For the people who are – surgeons who have initial experience obviously have to be careful of taking complicated cases. But for example, at Roswell Park, which is a referral cancer institute, we don’t have any requirement which says you can’t have this surgery if they are eligible for surgery. For example, if they don’t have a reason that they cannot get any kind of surgery, other than that they should be candidates for robotic surgery.

It is very helpful in patients who have had previous surgery, and we have seen over the time – we have a decade plus experience in this, and people who have had previous surgery and had more scarring this might be easier for them than having surgery on patients that have never had surgery. Everybody is eligible at Roswell Park for this kind of surgery unless it’s a contraindication as a surgery.

Bill: Okay, well that’s good news. Can you tell us more about bladder cancer specifically and the robot-assisted radical cystectomy?

Dr. Guru: Yeah, sure. Bladder cancer, as you know – and this is kind of one of the forums which we should talk about to patients is that it is something which can be – if you avoid smoking you kind of help yourself. Smoking is one of the major causes. It’s a health hazard, and we all should be aware that smoking leads to this including lung and other cancers. Bladder cancer is -- one of the common causes of -- is smoking.

What we need to do is we need to – sometimes when the cancer becomes invasive, we have to take the bladder out. For that bladder to be taken out, we have to then find another way of storing urine and making a new urinary diversion or new urinary outlet. For that, this operation involves a lot of effort, a lot of time, and you are involving multiple systems in the body. One is you are taking the bladder out. Two is then you have to make a conduit or a reservoir for your urine, so it’s two major things happening. A lot of these patients who have bladder cancer who need a cystectomy are elderly. Their mean age is about 70, so you have to basically make sure that the operation is gentle on them, and you don’t lose a lot of blood, and you do a good job.

That’s where the robot comes into play, and it does a good job at that, okay? We’ve been doing robotic surgery for bladder cancer – one of the first places in the world to do this – since 2005, which is about 12 years back. We have a ton of experience with this, and we have seen that this is very helpful for our elderly patients. They recover well, they heal well, and they return to their normal activity. One of the causes also is less blood loss, being gentle on the tissues, having smaller incisions.

Bill: Well, this sounds perfect for an elderly patient. Dr. Guru, you’ve recently reached the milestone of 500 cystectomy operations. That is quite an achievement, congratulations. What does that mean to you?

Dr. Guru: Well, I think it means a lot more to our patients. It means a lot more to our region and the community. This is the largest experience in the world. One of the things which it shows is that if we jump into this new field 12 years back and the community and the patients are seeing the fruit of it, that we have the experience and we can deliver this to our patients. Number two, it means that we are a very experienced center and we have trained a ton of people around the world to do this. And number three is that this operation is going to stay and it’s going to evolve to get better. As it gets better, it’s going to be better for patients. Ultimately, the goal of the surgeon, the team, and the institute is to drive home better patient care, and that’s what we’re doing.

Bill: Um-hum and that number is significant because it shows the success of this type of surgery, right?

Dr. Guru: Yes, exactly. Especially when we started, it was still in its early infancy, and now, we’re masters in the field, and it’s a good thing for our patients.

Bill: And can you tell us more about the Day at the Park, Bladder Cancer Event, on Saturday, July 29th, 2017?

Dr. Guru: Absolutely, and I think I’m very excited about this day because this is a day which we set out to celebrate our patients and their lives and their struggles and their fights against cancer and how they have been brave enough to fight it. We have been lucky and fortunate at Roswell Park to partner with them in doing this. This is all this is about. It is a day to celebrate these patients. It is a day for their families to spend time with them.

On top of it, we put our specialists on duty to talk about – we have several seminars talking about different aspects of side effects, complications, and after effects of treatment which we can take care of. For example, physiotherapy, therapy for sexual dysfunction, nutrition, health, loss of appetite, loss of – all of these things and how do you cope with these things? We have multiple seminars, we have a celebration in the park, we have all of these things happening, and the whole focus is the patient and their families.

Bill: Well, thanks for sharing that information with us, Dr. Guru. You can find more information at RoswellPark.org. And Dr. Guru, can you tell us what sets Roswell Park Cancer Institute apart in the area of robotic surgery?

Dr. Guru: Oh, it’s very simple. Number one, we pioneered the field in areas of bladder surgery, for example. We have a very, very good, dedicated team. We have very experienced surgeons. The most important thing is that you have everything under one roof. You don’t have to go place to place to search for expertise. They have good teamwork. There’s good communication between our different departments, and all of us focus on cancer for the last 100 years. As you know, we are the oldest cancer institute in the world. This brings a lot to the plate for the community and the region because you have the expertise, you have teamwork, and you have a lot of good support. This is ideal for patients.

Bill: That experience is very comforting. Thank you, so much for sharing your time with us today, Dr. Guru. We appreciate it. For more information, you can visit RoswellPark.org and once again, that’s RoswellPark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth. Thanks for listening.