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The Evolution of Robotic Surgery at Tulane Health System

Robotic surgery is an example where technology, coupled with the expertise of surgical teams, has enabled physicians to better care for patients.

Por: William Lunn, MD,President & CEO, Tulane Health System

Around the world, healthcare continues to evolve to benefit patients. From personalized genetic medicine to advances in medical equipment, we are seeing technology drive improvements in clinical quality and outcomes. Robotic surgery is an example where technology, coupled with the expertise of surgical teams, has enabled physicians to better care for patients. At Tulane Health System in New Orleans, Louisiana, surgeons continue to find novel applications for robotic technology.

For example, the first-ever robotic thymectomy was performed recently on a 14-year-old patient by Dr. Emad Kandil, Chief of Endocrine Surgery at Tulane University School of Medicine. This new technique used only one incision under the arm, an area known as the axilla, to get to the gland to remove it. Thymectomy is a surgical procedure to remove tumors from the thymus, a gland located at the base of the neck. Traditionally, surgeons had to split the breastbone to remove the thymus, requiring a long incision in the chest and leading to more recovery time for the patient. There is greater pain and risk of infection with the traditional technique.

Dr. Kandil is a pioneer in performing transaxillary thyroid surgeries in the same way. He uses a robotic surgery system that provides an enhanced, high resolution magnified view of the anatomy around the thyroid, which enables him to perform precise surgery through a single incision under the arm. Using this minimally invasive approach, the scar is hidden in the armpit, patients heal faster and many are able to go home the same day.

Tulane’s journey to become an international leader in robotic surgery techniques was years in the making. Tulane surgeons were the first to perform robotic surgery in the Gulf South region of the United States. Our doctors have pioneered minimally invasive procedures for over two decades and offer expertise in laparoscopic and robotic surgery using the newest da Vinci® Xi Robotic Surgical System at two of our three Tulane campuses.

It’s not enough to have the robotic technology available – it’s equally important to have a surgical team with extensive experience in using it for common and complicated procedures. As our robotic surgery program has matured, the team developed specialized skills to handle complex procedures, including transoral surgery for cancer in the tongue and advanced urology cases.

“As surgical teams advance their skills using the robot, new uses for the technology evolve,” said Tulane’s Chief of the section of Urologic Oncology, Dr. Jonathan Silberstein. “For example, the specialized dual console robot at Tulane allows two surgeons to operate concurrently alongside one another, using a multidisciplinary approach for more complex cases.”

Dr. Antonio Barrios, Director and International Liaison for Advanced Urological Care, added, “One aspect that makes our robotic surgery program unique is our multidisciplinary team approach in an academic environment. Providers from different specialties work together so that patient care is comprehensive and integrated, not fragmented.”

Recognizing the role of referring physicians, Dr. Barrios also noted, “Part of our team approach involves communicating with patients’ primary care or specialty physicians who usually manage the patient’s day-to-day and follow-up care.”

Because of our expertise using robots in surgery for many specialized procedures, we are often able to care for patients with rare or complicated conditions that other doctors might not be comfortable treating. “We take pride in treating patients who otherwise couldn’t receive care,” Dr. Barrios said.

As part of an academic medical center, the Tulane team also feels an obligation to share our knowledge and educate other surgeons. We host week-long training sessions for four visiting fellows from other countries who come to New Orleans to participate in hands-on education using the robot in surgery. These fellows are able to take this knowledge back to their home countries where they practice.

Dr. Silberstein, for example, uses innovative new technology while training others to use robots. “We’re starting to use 3D printers to print replicas of organs, such as kidneys, so trainees can practice surgery on an exact model of soft tissue,” he said.

I am excited to see what our surgeons can do next with robot technology, and how we can share this innovation with others. Healthcare providers have an obligation to create and use technology to better care for patients. And the investments of time and resources are worth it when patients benefit.

Tulane Health System is home to three hospitals in the greater New Orleans, Louisiana, area of the United States of America. Two of its member hospitals, Tulane Medical Center and Lakeview Regional Medical Center, offer robotic surgery services with da Vinci® robots. Have questions or need more information about Tulane Health System’s robotic surgery program? Please contact us at [email protected]


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