Overlake surgeons Eiji Minami, MD (left), and Adel El-Ghazzawy, MD.

The Cutting Edge

Overlake surgeons Eiji Minami, MD (left), and Adel El-Ghazzawy, MD, are leading experts in an advanced type of minimally invasive surgery.

“The best part of using the robot is the visualization — the magnified, three-dimensional view,” says Adel El-Ghazzawy, MD. “Since we’re able to see what we are doing so clearly, we are able to work efficiently and with great safety.”

Just four months after Erica Matsushima delivered her firstborn baby at Overlake Medical Center, she returned to the medical center to have her gallbladder removed in a groundbreaking robotic surgery that required only one short incision in her belly button. Hers was the first such single-site robotic procedure at Overlake and one of the first of its type in the region.

Thanks to the advanced technology and her surgeon's skill, Erica checked in and returned home the same day. She says she's very pleased with her experience at Overlake and her speedy recovery.

"When anybody asks, I sing Overlake's praises," says Erica, who lives in Bellevue. "Everyone at the hospital was wonderful. I always felt like I was in good hands. Any time anybody asks about my surgery or my delivery, I let them know Overlake is a great place to be a patient."

A Leader in Robotic Surgery

Erica's positive experiences have been shared by countless patients at Overlake. Since establishing its robotic surgery program in 2010, the medical center has become a regional leader in the field and now offers robotic-assisted procedures in urology, gynecology, weight loss surgery and general surgery.

Robotic surgery is an advanced type of minimally invasive surgery, explains general surgeon Adel El-Ghazzawy, MD, who performed Erica's procedure. In contrast to the single, long incision used in open surgery, robotic procedures and conventional laparoscopic procedures use one or more short incisions to insert a tube. The tube (or tubes) allows physicians to deploy tiny video cameras and specially designed instruments to perform procedures.

Robotic surgeons at Overlake use the da Vinci® Surgical System, which has a camera arm and interactive mechanical arms, with joints that work like the human wrist. Seated at a console a few feet from the surgical table, the surgeon skillfully guides the procedure, viewing the surgical field on a monitor that provides more depth perception and detail than does open surgery.

Appreciating the Robot's Advantage

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"For me, the best part of using the robot is the visualization — the magnified, three-dimensional view," says Dr. El-Ghazzawy. "Since we're able to see what we're doing so clearly, we're able to work efficiently and with great safety."

"Robotic instruments are much more nimble," adds Eiji Minami, MD, who also uses the high-tech equipment in general surgery procedures at Overlake. "Laparoscopic procedures are done with sticklike instruments, but robotic instruments have wrist action. It's like using your hands inside the body."

With the benefit of the robot's added dexterity and precision, surgeons can perform delicate and complex procedures that can be difficult or impossible using other techniques. That means more patients can be candidates for surgery. And those who do undergo robotic-assisted procedures may have less blood loss and reduced trauma, a shorter hospital stay, fewer complications and a quicker recovery than those who have open surgery.

Growing Trends in Robotics

Overlake's Robotic Surgery Program has come a long way since its beginnings. In 2010, surgeons in the fields of urology and gynecology became the first at the medical center to use robotic equipment. (That first robot has been affectionately dubbed "Rosie," named by OR staff after the robot on the popular '60s TV series The Jetsons. Overlake purchased a second da Vinci system in early 2012.)

Using the robot to remove the prostate gland (radical prostatectomy), for example, has allowed Overlake physicians to perform highly precise movements that protect the delicate prostate nerves controlling bladder and sexual function. That's one of the reasons the robotic procedure is now the predominant surgical treatment at Overlake for localized prostate cancer. Gynecological procedures are also among the most common robotic-assisted procedures at the medical center. These include removal of the entire uterus (hysterectomy) and removal of symptom-causing fibroids (noncancerous growths on the uterus).

In July 2011, Overlake surgeons began using the robot in weight loss (bariatric) surgery, which helps patients lose weight by reducing the size of the stomach. "Already, robotic-assisted procedures account for about half of our bariatric cases," says Thien Nguyen, MD. "Our program probably does more bariatric robotic procedures than any other program of its type in the state. It's like science fiction come to life. My patients think it's very cool. They're really excited to be part of a new wave of doing things with technology."

The robot's December 2011 debut in general surgery procedures was a landmark occasion at Overlake and throughout the Eastside — as much for what it portends for the future as for its initial use in gallbladder removal, anti-reflux procedures and certain hernia repairs. "I think there will be pretty widespread use of the robot in general surgery in the coming years," says Dr. El-Ghazzawy. "Overlake is being proactive in introducing this technology and visionary in devoting its resources to this growing field."

Continue to the Robotic Weight Loss Surgery article to read how Overlake's Robotic Surgery Program changed the lives of the Auburn family.

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