‘Blown away:’ Da Vinci surgery robot completes 200 surgeries

The future has arrived at St. Paul’s Hospital.

The facility’s Da Vinci Surgical System has completed 225 surgeries in less than a year.

The robot — which is named Daryl after Merlis Belsher’s son — completed its first surgery on Sept. 12 of last year.

When surgeries first began with the Da Vinci robot, patients were made aware of the fact that a robot might be used.

“Initially we had to tell a few patients, ‘We haven’t really done this before, but we’ve had some training and here’s how it’s going to go,’ and most of the patients were actually really excited,” said Dr. Varun Bathini, a urologist and the provincial lead for robotic surgery.

Bathini was trained in robotic surgery during his residency.

“I got exposed to it in my residency eight years ago, and it’s been primarily used in urology and gyne oncology,” said Bathini. “When I came to Saskatchewan I wanted to do robotic surgery so it’s been a project I’ve had to go through several meetings and get people on board.”

Dr. Dimitrios Coutsinos, a thoracic surgeon at St. Paul’s, and Dr. Richard Bigsby, the division head of thoracic surgery, both trained in robotic surgery in Atlanta.

While both doctors were in Atlanta, they were told that when it comes to urology, robotic surgery has been the method of choice in the United States for a few years.

“When we were training to be able to use the robot, Dr. Sancheti of Emory Saint Joseph’s Hospital in Atlanta told us that today in New York City, 95 per cent of all lung resections are done robotically,” said Coutsinos. “To put things into perspective, we are the only centre in Western Canada to offer robotic thoracic surgery.”

Robotic surgery is considered the next step in the evolution of surgery in Canada, but in the United States, this type of surgery is the gold standard.

“Robotic surgery is the next step in the evolution of laparoscopic surgery. The hindrance so far has been cost because robotic surgery is expensive,” said Bathini. “In the States where the cost isn’t as prohibitive, every major hospital has several robots.”

At the very beginning of using the robot, there were learning curves that everyone had to get used to.

“One of the learning curves is the movement of your hands to mimic what you’re doing,” said Bigsby.

All three surgeons agreed that operating with the Da Vinci robot is easier.

“It makes surgery incredibly more precise and I think it makes surgery a little bit more safer,” said Coutsinos. “You are capable of dissecting things with greater precision and you’re capable of seeing stuff that ordinarily you are not capable of seeing.”

One of the more noticeable changes is the size of the incision on patients isn’t as large as it would normally be.

Such a cool experience seeing the Da Vinci surgery robot up close. Huge thanks to the staff at St. Paul’s Hospital and the @SaskHealth for allowing me to come see the robot. #YXE #Robot pic.twitter.com/MpKKgQNfmb

— Will Mandzuk (@WMandzuk) August 29, 2023

“The incision isn’t as big and we are able to do surgeries that we otherwise couldn’t do while being minimally invasive,” said Bathini.

“In thoracics, when we did traditional open surgery, we would have to spread the ribs which is very painful,” said Coutsinos. “With the robot, all of our incisions are small and are lower on the chest. This results in our patients going home very quickly.”

The robot is very precise when it comes to dissection and according to all three surgeons the robot is able to do incredibly detailed work.

“The aorta has its own blood supply, so there’s blood vessels on top of other vessels and with this robot, if you wanted to, you could dissect those vessels on top of the other vessels,” said Coustinos.

The robot itself has two different pieces of equipment. The patient carton is four large robotic arms that get positioned over top of the patient and those are the arms that go inside the patient with the instruments.

The other piece is a console that the surgeon sits at. The console, which is located a few feet away from the patient, has controls that allow the surgeon to manipulate the arms inside of the patient. There are also foot pedals that control the camera and other instruments.

(Will Mandzuk/650 CKOM)

Using the robot to complete surgeries has helped with the recovery time for patients. Coutsinos said he had a patient that went home 13 hours after the robotic surgery.

“What we’re noticing with robotic surgery is that our patients are going home earlier and that’s offsetting some of the costs,” said Bathini. “(That includes) patients even in laparoscopic and video-assisted thoracoscopic (VAT) surgery, which is something we didn’t expect.”

Robotic surgery is now the standard practice at St Paul’s Hospital.

All three surgeons are very proud of not only the reception of the robotic surgeries but with how smoothly they’ve gone over the last year.

“I’m blown away. I knew there would be good reception to robotic surgery but I didn’t think it would be this quick,” said Bathini.

“This was Dr. Bathini’s vision that started this whole thing. He got the ball rolling and really got everybody excited about this,” Coutsinos added.

Bigsby said they actually could use another robot.

“It’s been so successful that we need more. We’ve learned that we could almost use it every day of the week,” said Bigsby. “It’s coming to the point where we are going to have to make ethical decisions on who’s going to get the robotic surgery and who won’t.”

The number of surgeries completed with the robot is higher than anyone expected for the first year.

“The program has been incredibly successful and it has taken off. I think we’ve done more cases than we were expecting,” said Bathini. “I think we were expecting to hit these numbers by Year 5 and we’ve hit them in Year 1.”

This type of surgery has become so well-known among the health sector in Western Canada that not only are patients asking for the robotic surgery but they’re coming from other parts of Western Canada for the surgeries.

“It’s gotten to the point where patients are asking for it. Just the other day I had a patient and they wanted to know if they would be a candidate for robotic surgery,” said Coutsinos. “We are seeing more and more patients asking for robotic surgeries and they know the benefits, they’ve looked it up and seen the States are using robotic surgeries all the time.”

“Not only patients in the province are asking for it either. We have noticed that patients are coming from centres where they don’t have robotic surgeries,” said Bathini. “So we’ve received quite a few referrals from Winnipeg (and) we’ve gotten a few referrals from patients in Alberta.”

The Saskatchewan Health Authority has put in a formal request for a second Da Vinci robot.