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Richland's Kadlec Practices Artistry in Robotic Surgery (Courtesy Tri-City Herald)

By Michelle Dupler, Tri-City Herald

There was a day when a multi-armed robot wielding surgical instruments would have been the stuff of science fiction daydreams. But nowadays, the da Vinci Surgical System is a piece of cutting-edge technology that means some Tri-Citians can have more precise, less painful operations.

The $1.75-million robotic surgical system went live at Kadlec Regional Medical Center about three weeks ago, when Dr. Mark Mulholland performed his first surgery using the system. Although the robot's arms are making incisions and even stitching sutures in a patient, it's Mulholland who controls the robot's every move using a console from about eight feet away that gives him a magnified 3-D view of the patient. He grips a set of controls that allow his natural hand and wrist movements to translate to the robotic arms just as if his hands are performing the surgery. The da Vinci robot basically becomes an extension of the doctor -- a more precise extension that reduces blood loss and scarring compared with the type of laparoscopic surgery that has been the standard for a decade or so.

"With the robot you can go right to tissue. It allows you to go around corners, even tie knots inside the patient," Mulholland said. He said he's performing the same surgeries as before, just with better tools. "This is a huge step for the region," he said. "We're one of the last major regions in the state to adopt this technology."

Mulholland explained that patients won't be charged more for surgeries using the robot and it doesn't reduce the time it takes to perform the surgery. But it does improve the patient's recovery because it generally is less invasive and causes less blood loss. The da Vinci technology has been around for about a dozen years, but Mulholland said that being a late adopter allowed Kadlec to get a mature, proven technology in its latest form.

The robot primarily is used by surgeons specializing in gynecology and urology. At Kadlec, Mulholland and Dr. Larry Smith -- the two surgeons trained to use the system -- are gynecologists and so far are using the system primarily for hysterectomies, a surgery that involves removal of a woman's uterus. But Mulholland said the robot eventually could have applications for general surgeons performing gall bladder operations and even by heart surgeons. Pasco resident Cindy Lacy was the first Tri-City patient to undergo surgery using the da Vinci robot, and said she was surprised to be able to leave the hospital the same day.

Patients who have hysterectomies via a traditional laparoscopic procedure typically have to stay in the hospital a couple of days, Mulholland said. "It was nice," Lacy said. "I thought I would have to stay overnight. It didn't hurt at all." Before her operation, Mulholland showed Lacy the robot and walked through what would happen when her hysterectomy was performed.

Lacy said she didn't have any anxiety or hesitation about having her surgery performed using the da Vinci system. "I thought it was pretty neat," she said. "I thought it would be better than the old way of doing a hysterectomy." Mulholland demonstrated the limitations of laparoscopic surgery compared with surgery with the da Vinci system by showing how the surgical tools inserted through tiny laparoscopic incisions have less flexibility and range of motion than the tools attached to the da Vinci robot's arms -- namely that traditional laparoscopic tools can't pivot the way the da Vinci tools can.

He likened laparoscopic surgery to trying to tie a shoelace with two stiff fingers, while using the da Vinci robot is like tying a shoelace with the functionality of your entire hand. "This has helped us advance what we can do surgically at a very tiny level," he said.