New Horizons in Robotic Surgery: Precision Procedures

Doylestown Health surgeons are using robotic technology to perform more complex procedures through smaller incisions. "Robotic arms allow greater freedom of motion than the human hand," says Christopher Bruce, MD, who specializes in robotic colorectal surgery at Doylestown Health. "The increased dexterity allows for suturing and precise movements through tiny incisions."

"Robotic technology enhances what we can do laparoscopically," explains Ob/Gyn Scott Dinesen, DO. "We have better visualization than ever before with three-dimensional, high-definition views, and the robotic arms have wristed joints that bend and rotate 360 degrees."

"For patients, this means less blood loss, scarring and pain and a faster return to an active lifestyle," explains surgeon Brian Pellini, MD, chair of Doylestown Health's Robotics Committee and medical director of Minimally-Invasive Surgery at Doylestown Health.

"The recovery from minimally-invasive surgery is typically less painful in part from the smaller incisions, so patients don't take as much medication to manage post-surgical pain," explains Doylestown Health colorectal surgeon Robert Akbari, MD. "Given the current opioid addiction epidemic, that's an important benefit."

Robotics in Action

At Doylestown Health, specially trained surgeons use the Intuitive da Vinci® Surgical System to provide minimally-invasive options for colon and rectal, general, gynecologic and urologic procedures. Doylestown Health was the first in Bucks County to acquire the da Vinci Surgical System. And, to accommodate an ever-increasing demand and enhanced capabilities in robot-assisted surgery, a second system, the daVinci Xi, was added in 2019.

Sitting near the patient at an ergonomically designed console, the surgeon uses joysticks or finger grips to maneuver robotic arms and instruments. "We control four instruments with two hands and can fine-tune the system making it more or less sensitive to our hand movements," says Dr. Bruce.

Personalizing Care with Robotics in General Surgery

"Robotics has opened the door for minimally-invasive hernia surgery and other complex operations that involve suturing and tissue manipulation," says Dr. Pellini, who is fellowship trained in advanced laparoscopic and robotic surgery. "We use this technology for abdominal procedures, such as hernia surgery and gastrointestinal procedures including hiatal hernia repairs, reflux surgery and colon surgery.

"Hernia surgeries can be open, laparoscopic or robotic. We tailor the approach to the patient, considering the hernia's size and location and the patient's medical and surgical history," says Dr. Pellini. "For instance, patients with diabetes or other healing issues may benefit from smaller incisions away from the repair site to help decrease infection risk."

Easier, Faster Recovery from Colorectal Procedures

"In experienced hands, most colorectal procedures can now be done robotically," says Dr. Bruce, "This includes diverticulitis, removal of cancerous or benign tumors, polyps and lesions and inflammatory bowel disease (Crohn's and ulcerative colitis)."

"With a robotic colon resection (removing part of the colon), the only incision other than small ones for instruments, is the one to get the specimen out. We use a bikini incision just above the pubic bone, which is virtually scar-free," says Dr. Bruce.

"With less pain, patients take less pain medication, and they walk, regain bowel function and resume their diets faster. After a two or three-day hospitalization, patients generally resume normal routines within two weeks."

Helping Prevent Pregnancy Loss

Minimally-invasive robotic surgery is available for a variety of gynecologic procedures, including hysterectomy, treatment of deep endometriosis, pelvic adhesions and fibroids. For women who have had second trimester pregnancy losses caused by early cervical dilation, Dr. Dinesen performs a minimally-invasive, pre-pregnancy robotic cerclage, placing a stitch high in the cervix to help prevent early dilation.

"Placing the cerclage before pregnancy offers a 98 percent success rate for full-term deliveries, and robotic technology enables our patients to have the cerclage placed in a same day surgery, recovering in 24 hours as opposed to an open procedure with a six-week recovery," says Dr. Dinesen, one of a few surgeons nationally who performs the procedure.

Investing in Surgical Innovation

As part of the One Vision Campaign, Doylestown Health is creating a state-of-the-art surgical suite, adding another critical renovation and expansion that will benefit the health and safety of our patients and advance our culture of innovation and healing. The surgical suite will include over 16,000 square feet, with seven renovated and expanded operating rooms, including rooms specially designed for robotic surgery, as well as orthopedic and general surgery.