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Wexner Medical Center teaches others robotic surgery methods

Courtesy of Andrew Dollmatsch

Ohio State’s Center for Advanced Robotic Surgery has been guiding and training other hospitals in the country to help them expand into the robotic surgery world.
Dr. Jeffrey Fowler, the co-director of the Center of Advanced Robotic Surgery, said OSU physicians perform roughly 1,500 robotic surgeries per year and lead the field with an experienced robotic surgical staff.
OSU was the first in the country to perform heart surgery with the da Vinci robot in 1999, according to the Wexner Medical Center website.
The robot operates through small incisions, and with a range of motion greater than the human hand.
OSU owns four of these robots, which cost between $1.6 and $1.8 million each.
“Other hospitals have been sending their surgical teams to shadow and see what we do here,” Fowler said. “They (other surgical teams) spend time with our educational nurses and technicians … (practicing) on dummies as far as setting up the robot and positioning patients on the operating room table.”
The development of the Center for Advanced Robotic Surgery allows for expansion across specialties, Fowler said.
Although gynecologic oncology is the most common robotic surgery procedure done at the Wexner Medical Center, Fowler said, it also specializes in benign gynecology, gastrointestinal oncology, urology, cardiac, thoracic and general surgeries with the da Vinci robot.
The comprehensive robotics program offered at OSU “is a multidisciplinary program,” and Fowler said the goal after starting it five or six years ago was for it to be more comprehensive.
There are several benefits to having robotic surgery as opposed to a normal surgical procedure, Fowler said.
“The best way to think about it is just another piece of equipment, but just very high-tech,” he said. “The whole idea is doing a surgical procedure in a more minimally invasive fashion. We always did surgeries through big incisions or big enough to see what you can do and a lot of the side effects … of the surgery is due to the location of the incision and the size of the incision.”
Tubes attached to the robot are only eight to 10 millimeters in diameter. Because of the six small incisions given during surgery, the recovery rate is much faster compared to other surgeries. Patients have a three to five night stay with a regular surgery, but when the da Vinci robot is used, the patient can typically go home the following day, Fowler said. In addition, there is less blood loss and fewer side effects.
“You can do a more complicated task with the robotic equipment,” Fowler said. “Basically it’s the same idea as laparoscopic surgery – surgery through small holes – but the robot allows us to do more complicated tasks. The surgery is more precise because the instruments act as your wrists. There are more degrees of freedom and motion.”
Another advantage of the robot is its high-definition, 3-D vision.
“The robot has a camera (with) up to 10 times magnification, so it allows you to see into the body without having to make a large vertical incision from the pelvis to right above the belly button,” said Dr. Brent Tierney, a gynecologic oncology fellow at the Medical Center.
Although robotics perform the surgeries, these complicated procedures wouldn’t be possible without trained surgeons.
“There is nothing magical about it, the surgeon is performing the surgery,” Fowler said. “The most important resource is having skilled surgeons and knowledgeable surgeons … we pretty much have that all on board here at OSU. Ohio State has been very supportive of us … We just keep continuing to train younger surgeons.”
Dr. Georgia McCann, a gynecologic oncology fellow at the Medical Center, encourages undergraduate students interested in a career as a surgeon or in the medical field to get involved now.
“There are plenty of ways to get exposure,” McCann said. “We have undergraduate students come in all the time and see what it is all about and watch a case.”
Fowler said for students to seek out mentors, they should contact the medical school or volunteer at the hospital to gain more experience.
“I have been contacted a number of times by undergraduate students to shadow in the operating room and we’re very open to that,” Fowler said. “Obtaining experience with any type of medical or scientific research … is valuable later in a career in medicine.”

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