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New Robot Gives Doctors a Hand

Gulf Coast Medical Center the first to use da Vinci Surgical System on a child in Bay County

April 15, 2010, SCARLET SIMS / News Herald Writer

PANAMA CITY—Eight-year-old Trevonn “Tre” Stevenson lay unconscious on the surgery table at Gulf Coast Medical Center while Dr. Michael Taylor used 5 mm surgical tools to suture a hole in the boy’s stomach from the inside. Taylor performed the first pediatric surgery in the area using new robot-assist technology called the da Vinci Surgical System. “This is the first robotic pediatric case that has been done in this area and one of the few in the state of Florida,” Taylor said.

Taylor has used the technology on about four cases so far.

Three robotic arms stretched over Stevenson’s abdomen during surgery Wednesday. The doctor used tiny incisions, or “ports,” for a camera and gripping, cutting and burning tools that could be exchanged on two arms. Taylor operated the arms from a separate station where he could see Stevenson’s stomach and liver in 3-D. The station and mechanics are similar to a video game, Taylor said.

The light from the camera inside the boy made his skin glow red while nurses followed Stevenson’s progress on two video screens as the doctor removed scar tissue.

“It’s like taking your hands, making them the size of your fingers and being able to rotate them around,” Taylor said of the machine. “It’s much easier with the robotics.”

The da Vinci Surgical System, which the hospital bought for $1.6 million, means children like Stevenson can have less-invasive surgery. Those three small incisions are likely to mean less pain and more healing, Taylor said.

“We’ve had several people waiting for the robot so they can have a hysterectomy here,” said Cathy McDonald, inservice and educational coordinator with Gulf Coast Medical Center. “The only problem is they say they forget they just had major surgery.”

People are signing up for the robot-assist surgery every day — sometimes three sign up in a day, McDonald said. So far this year, the hospital has had more than 80 cases that doctors decided should use the robot-assist equipment. The hospital got the da Vinci in November and its first case was Dec. 7. As word spread, more people are checking out the system for minimally invasive surgery, McDonald said.

Da Vinci offers greater surgical precision and range of motion than other methods, nurses and doctors said Tuesday. Using the da Vinci means patients have less blood loss, shorter hospital stays, less pain and less risk of infection, said Nicole Bunn, clinical sales representative with Intuitive Surgical, the company behind da Vinci.

“These machines have wrists so they move,” Bunn said. “Regular laparoscope is like working with chopsticks.”

A hysterectomy that once took six weeks to recover from takes about three with the da Vinci, said nurse Lorena Hottinger, a da Vinci coordinator.

In Stevenson’s case, he used a feeding tube for medication and food since he was born. When Stevenson was strong enough not to need the tube, his body didn’t heal the holes left over. Those holes could become infected, Hottinger said.

Had Taylor not used the da Vinci he would have had to open Stevenson up much more than the 1 to 2 cm incisions needed for da Vinci, he said. Doctors determine what cases suit the equipment and spend time training. Taylor finished his training two months ago. He said he would like to see a pediatric program built on the robot-assist system, he said.

Doctors are considering expanding from prostate and gynecology surgeries into areas like thyroid surgery, perioperative services director Diane Warner said, but most da Vinci candidates currently are in need of hysterectomies.

Taylor said the technology is improving how people recover from surgeries.

“What I’m really excited about is the future,” Taylor said. “It’s pretty awesome just the technology behind it.”

Just before 2 p.m., Taylor finished stitching up Stevenson’s incisions. The surgery went well, he said.

Stevenson’s mother, Brenda James, was relieved. She said she wished the da Vinci had been available earlier so her son wouldn’t have suffered so much from previous surgeries. Keeping pain to a minimum is important, she said.

“It’s really important, especially for a very active boy,” James said.