Robotic Surgery

Our da Vinci Program is the Most Robust in the Region

Community Memorial Hospital, a leader in state-of-the-art medical care, was the first hospital between Los Angeles and San Francisco to acquire the da Vinci Surgical System.

How the da Vinci Works

During surgery, the surgeon sits at a console across the room from the patient, monitors the video screens and directs the robotic arms. The surgeon simply makes three or four tiny incisions measuring a mere 1 to 2 centimeters in diameter using the da Vinci instruments. The da Vinci system has up to four arms that are inserted into the patient through the incisions. One arm holds a miniature camera and the other arms hold instruments. Through these ports, the surgeon is able to navigate the robotic instrument arms and endoscopic arm during the procedure while sitting at a console several feet away from the operating table. A magnified 3-D system gives the surgeon an enhanced view of the surgical field.

The da Vinci seamlessly and directly translates the surgeon’s natural hand, wrist and finger movements on instrument controls at the surgeon’s console outside the patient’s body into corresponding micro-movements of the instrument tips positioned inside the patient through small incisions. It maintains a corresponding eye-handinstrument alignment, so that as a surgeon twists the controls in one direction, the instruments twist in the same direction, giving the surgeon natural hand-eye coordination. In standard laparoscopic surgery the movement of the instruments is ‘counter-intuitive’ similar to doing surgery while looking into a mirror.

The CMH da Vinci Trained Surgical Team:
Back Row, L-R: David Crownover, M.D., Douglas A. Woodburn, M.D., Marc A. Beaghler, M.D., Helmuth T. Billy, M.D., Michael M. Salehpour, M.D., Joseph A. Eisner, M.D., Cedric B. Emery, M.D., Seyed M. Khoddami, M.D., Patrick McCarty, M.D., Kayvahn P. Steck-Bayat, M.D., Brian C. Tuai, M.D., Shawn T. Steen, M.D.
Front Row, L-R: Anne O. Rodriguez, M.D., Jennifer J. Wan, M.D., Lisa E. Brand, M.D., Srisawai Pattamakom, M.D., Lamar J. Bushnell, M.D., Edwin R. Ramirez, M.D., Jill C. Hall, M.D., Constanze S. Rayhrer, M.D., Michelle M. Takase-Sanchez, M.D.

The Development of Robotic-Assisted Surgery

The past two decades have witnessed a revolutionary transition in surgical technique and technology. Traditionally, surgeries had been performed in an open manner, in which large incisions were required for the surgeon to plainly observe and manipulate the surgical field. These incisions inevitably created significant patient trauma, substantial pain and suffering, extended recovery time, prolonged pain management and elevated costs.

Approximately 20 years ago, surgeons began practicing a new approach to performing surgery, an approach that came to be known as minimally invasive surgery, or MIS. During this era, tiny cameras in instruments called endoscopes or laparoscopes were introduced. These visual and surgical aids could be inserted into the patient’s body through small ports.

Although revolutionary in its positive effect on patient trauma and recovery times, MIS encountered significant technical drawbacks. The surgeon operated using a standard 2D monitor instead of looking at his or her hands. The resulting image flattened the natural depth of field, and the fixed-wrist instruments limited his/her dexterity. The lack of 3D visualization of the operative field, the poor ergonomic design and reduced control were major roadblocks to further progress. As a result, the type of MIS turned out to be suitable for a narrow range of surgical procedures.

In the late 1990’s, another evolutionary stage in the development of surgical technique was achieved with the application of robotics to surgical technology. At the forefront of this new era, Intuitive Surgical introduced the da Vinci Surgical System. The da Vinci System features wristed instruments with seven degrees of freedom, three dimensional, intuitive visualization and ergonomic comfort. These innovations created the pre-conditions for minimally invasive solutions to complex procedures in a wide range of surgical specialties. Today, Intuitive Surgical’s products continue to enable a new generation of surgical advancements, providing benefits to surgeons, hospitals and patients.

da Vinci System Benefits Your Surgeon

  • Enhanced 3-D Visualization
  • Improved Dexterity
  • Greater Surgical Precision
  • Improved Access
  • Increased Range of Motion
  • Reproducibility

da Vinci Benefits You the Patient

  • Reduced trauma to the body
  • Reduced blood loss and need for transfusions
  • Less post-operative pain and discomfort
  • Less risk of infection
  • Shorter hospital stay
  • Faster recovery and return to normal activities
  • Less scarring

State-of-the-Art Robotic Surgery Procedures Currently Performed at CMH:

  • Adrenalectomy
  • Colectomies
  • Colorectal Surgery for Cancer & Diverticulitis
  • Colostomy Closure
  • Endometriosis
  • Gastrectomies
  • Gastrectomy for Cancer
  • Heller Myotomy (for Achalasia)
  • Hiatal Hernia Repairs
  • Hysterectomy
  • Myomectomy
  • Nephrectomy & Partial Nephrectomy
  • Nissen Fundo-plications/Acid Reflux Surgery
  • Oophorectomy
  • Ovarian Sparing Cystectomy
  • Pyeloplasty
  • Pyloroplasty
  • Radical Prostatectomy
  • Sacrocolpopexy
  • Splenectomy
  • Ulcer Surgery
  • Vaginal Vault Suspension
  • Vagotomy

From the CMHS Blog:

CMHS Reaches Robotic Surgery Milestone with Over 2300 Successful Procedures ▶