By Dylan Wilcox | [email protected]

Vince and Leo, the newest additions to Alta View and Riverton Hospitals, were introduced recently to assist surgeons in performing minimally invasive surgeries. The surgical robots are seen as an overdue investment in patient care for the Sandy and Riverton communities, and will provide patients with mobility issues the opportunity to receive needed procedures without traveling far from home.

“The technology we have now is better for the patient. So the main reason Riverton now has a robot is because we are now seeing advantages of robotics and it’s not just at major medical centers. It is good for everybody, every patient,” Dr. Cabot Murdock, a surgeon at Riverton Hospital, said. According to Murdock, Intermountain Healthcare has had robotics in their surgical wards for years now, but adding Leo and Vince to Riverton and Alta View Hospitals, respectively, allows for greater flexibility in surgical offerings.

The advantages of having these particular units in surgical rooms is with minimally invasive procedures, it decreases patient dependence on narcotics for pain management, thereby accelerating the healing process and preventing patients from developing an addiction to pain medication. Further, use of robots has been shown to decrease the time a patient has had to stay in the hospital, reduce infection, decrease blood loss and quicken recovery time.

“In my experience, [the benefits of Leo are] less use of narcotics, fewer infections, less pain and patients are able to get back to their lives very quickly,” Murdock said. “I’ve been doing robotic surgeries for nearly four years without a single infection. That’s 300 cases without a single infection. I track my narcotic uses, and most of my hernia patients are using no narcotics and their overall outcomes they are very satisfied, and they are out moving around very quickly. And they’re not languishing in pain and what not. So, the precision driven component of the surgery makes your outcomes better and that’s what I see in my practice,” he added.

Leo and Vince are produced by a company called Intuitive which has a line of surgical robots named after famous Italian artist and inventor Leonardo da Vinci. The Da Vinci robotic platform by Intuitive has “pioneered new capabilities in the operating room, transforming the field of minimally invasive surgery,” their website says. “Through more than 8.5 million surgeries, Intuitive has become the proven leader in surgical robotics, increasing the adoption of minimally invasive surgery.”

The robots are made up of three major components. First is the patient cart, which houses the robot’s surgical arms and instruments that perform the actual operation. Second is the surgeon console, which is where the actual surgeon performs the procedure through the use of wristed instruments, optimized viewing in 3DHD of the surgery, and built-in tremor filtration minimizing unintended movements. And lastly is the vision cart, which holds the vision and energy technologies for the Da Vinci system. It also is the hub for generating power, creating detailed images and main home for the complex information system. These units are equipped with multiple indicators which alert the surgeon should something be wrong with one of the surgical arms or instruments, as well as alerts about the information technology. The overall system has proven to be very safe and very successful.

“These units are able to do a lot of GYN surgery, urology,” David Hurst, Nurse Administrator at Alta View Hospital, said. “Which allows for the patient to have quicker healing time, among other benefits, as well as being state-of-the-art technology that most of our physicians are trained to use these days,” he said. Vince has been at Alta View Hospital for just over a month now and will be utilized to help with complex procedures requiring a steady and precise hand. “The procedure would be performed by the same surgeon that would do it the old way, just with a robot,” Hurst added.

While the mainstay procedure of these robots has been hernias, surgeons hope to expand their capabilities by performing other operations such as gynecologic, urologic, thoracic, cardiac and general surgeries. Murdock emphasized that the robots are not replacing surgeons, the surgeon is very much in charge during actual surgeries. The robot is an extension of their abilities.

“The term ‘robot’ is actually a misnomer – it’s robot-assisted. Because the robot is doing nothing artificial. The robot is only doing what you command it to do. So, it’s really not a robot – it’s not self-automated. It doesn’t have any thought processes; it doesn’t have any processes that it goes through. It won’t allow you to do certain things – you know you’re trying to do a certain movement and it will say – ‘No, you’re not doing that!’ Because you’ve twisted the arm in a way where you can’t move it anymore. So, there are some limitations about your movement, but then all you have to do is back up and readjust, and then you can do your procedure. So, it has its limitations of exactly how you’re twisting your wrist, but the robot does nothing artificial. We prefer to call it robot assisted,” Murdock said.

Murdock recounted an experience with a patient who underwent a surgery with Leo, an 83-year-old woman needing a hernia removed.

“About three and a half years ago I did my first robotic case. I had to recruit the patient and tell them, ‘We’re doing something for the first time on a human patient – for me – will you be accepting of it?’ And we had a great outcome. They said, ‘I would be more than happy to do that,’” he recalled. Because of the patient’s advanced age, Dr. Murdock was confident the convenience Leo presented by keeping the operation at the Riverton Hospital would make the procedure worthwhile.

“I wasn’t going to offer her robotic surgery at another facility because I want to make sure she’s taken care of completely. But since we got the robot here, I told her listen – ‘If you will wait, I’ll do your surgery here and if you have any heart problems, we are right on it, and I feel comfortable in my own hospital,’” Murdock said. “And so, I said, you’re not obstructed – so when we get this robot – we are ready to go. And so, I got three patients to wait for that first day, and she was one of them. And she was a sweet lady and everything. After surgery, she had no pain, she didn’t use any narcotics. It was a good experience for the family. And then she had no heart problems. If I didn’t have a robot here – I was probably going to do an open hernia surgery on her, which is longer recovery, increase risk of infection and more pain. That fact that we got the robot here – I could operate on her here and get those outcomes. Whereas I was kind of reluctant to another facility and take her and if she had a heart problem – well then, we are all stuck up there away from our families and home. So, it really does change what I do, having [Leo] here. Because now I can offer that good surgery. She did fine. She had a good experience. She loved it so much, she didn’t want to go home the same day,” he added.

The Alta View Hospital offered an open house for members of the community to observe the robot, Vince, up close. A demo model of the machine was available for anyone to see how the controls work on the device itself. Vince at Alta View Hospital and Leo at Riverton Hospital are now available for patients being operated through the careful touch of well-trained surgeons.

Murdock sees the future of surgery being transformed for the better. “Come to Riverton, we’ve got state-of-the-art technology. This is what we’re going to do for you. And that’s what I’m so excited for. I’ve been waiting three years to get a robot here,” he said.