Dr. Su, chief of the division of robotic and minimally invasive urologic surgery in the department of urology, moves the robot’s tiny joysticks with his fingers while his feet simultaneously work the console’s pedals. Su was performing a robotic prostatectomy on a patient. Photo by Jesse S. Jones
At first glance, the draped patient on the table looks like he is being operated on by a hovering metal spider made of four arms with glowing blue lights and rods holding tiny metal tools.
But the real surgeon is Li-Ming Su, MD, who works hunched over a console in the corner of the operating room.
Moving tiny joysticks with his fingers while his feet simultaneously work the pedals, Su peers thorough the console’s lens, providing him a 3-D view of his surgery magnified more than 10 times.
Nearby, two urology residents stare at one of the computer screens illuminating the dark operating room. As Su describes his movements at the console, they watch the robot’s tiny metal tools cut and cauterize tissue inside the patient’s body.
“It’s a coordination of moving your arms and your feet at the same time to perform robotic surgery,” said Su, chief of the UF department of urology’s division of robotic and minimally invasive urologic surgery. “I don’t even think about it now, it feels so natural.”
In the past five years, the UF Multispecialty Robotics Program at UF&Shands has grown dramatically.
It began in 2007 with one urologist and one da Vinci Surgical System robot, said Su, the David A. Cofrin professor of urology who joined the UF faculty in 2008.
Today, the program boasts 22 practitioners in five specialties using three robots. It also includes the urology department’s outreach clinic in Winter Haven, where Sijo Parekattil, MD, a specialist in male infertility and microsurgery, performs robotic surgery.
A glimpse of the operating room during a transoral robotic procedure to remove a throat tumor. Photo by Maria Belen Farias
Many medical institutions offer robotic urology and gynecology surgery, but UF’s program stands out for providing new cutting-edge robotic surgeries, such as ear, nose and throat, gynecologic oncology, thoracic, bariatric and colo-rectal robotic procedures.
Robotic surgery is popular because it results in smaller incisions, less blood loss, fewer transfusions and shorter recovery times compared with traditional open surgery. Robotic surgery marries the ergonomic benefits of open surgery with minimally invasive approach of laparoscopy. This, combined with the enhanced high-definition visualization and magnification, allows surgeons to be more precise when performing surgery, Su explained.
Sometimes the difference is dramatic.
For example, robotic ENT surgery is done transorally, using snakelike tools to operate through the opening of the mouth. The advantages are no incision and better access to hard-to-reach areas.
“We don’t have to split the jaw to get our hands in there,” said Mikhail Vaysberg, DO, assistant professor in UF’s division of head and neck oncologic surgery.
Robotic thoracic surgery, which is used for lung surgery and other procedures, can also put less stress on the patient, said Charles T. Klodell, MD, an associate professor of thoracic and cardiovascular surgery. Traditional surgery can involve large incisions and cutting through the ribs.
“It’s a very versatile technology,” said Klodell.
Mikhail Vaysberg, DO, an assistant professor in UF’s division of head and neck oncologic surgery, works at the robot’s console, while ear, nose and throat resident Brian Boone, MD, sits beside the patient and assists with the robot’s tools. ENT transoral surgery is one of the newest specialties offered by UF’s robotics program. Photo by Maria Belen Farias
UF’s robotic program also is unique in its commitment to education and research aimed at examining patient outcomes and improving the technology itself.
Diagnosed with prostate cancer, New Orleans resident John Shepherd came to UF in 2010 for treatment. Su performed a robotic prostatectomy on Shepherd, who went home a day after the surgery and has been cancer-free ever since.
Shepherd said he was so impressed with Su’s level of expertise, plus his commitment to advancing the technology through education and research, that he made a donation to Su’s work. Shepherd contributed $10,000 to Su’s research, which is focused on improving prostatectomies and preventing nerve damage in the prostate area, while his employer, Entergy Corporation, matched his gift with another $10,000.
“The expertise at UF today is just phenomenal,” said Shepherd, a UF alumnus. “It’s enough to make Gators everywhere really proud.”
The UF Multispecialty Robotics Program at Shands at UF has performed more than 2,100 robotic cases since its inception in 2007. Here’s a look at how it has grown over the past few years:
Number of robotic cases in 2007: 93
Number of robotic cases in 2011: 568
Specialties in 2007: urology
Specialties in 2012: urology, gynecology and otolaryngology (2009), general surgery (including bariatric and colorectal) and thoracic surgery (2011)
Robotic surgeons in 2007: one
Robotic surgeons in 2012: 22, including 17 with advanced fellowship training
