Helping Hands with the Assistance of a Robot named Da Vinci

To me, robotic surgery is the most exciting type of minimally invasive surgery for children, because it allows me to perform surgery that we have been doing for many years. But now we are able to perform this surgery using the robot and tiny incisions.

The scars after robotic surgery are very small and often disappear over time. Robotic surgery in children leads to shorter hospital stays and a reduced need for pain medication after surgery, and the recovery time following robotic surgery appears to be faster than with traditional surgery, which allows children to get back to school faster, and parents to avoid taking too much time off from work.

Over nearly a decade of treating children and performing several hundred robotic surgieries in children, I have seen countless patients and parents who are happy that we were able to provide robotic surgery, since this usually meant that they only spent one night in the hospital.

While we recommend only light activity for the 1st few weeks after surgery, one teenage patient mentioned that she even went dancing only a few days after surgery (I don’t recommend this). Another young patient and her 11-year-old sister opened a lemonade stand to raise money for the hospital since they were pleased that the hospital offered this latest technology.

Some of the most common conditions that we treat with robotic surgery are:

  1. Kidney blockages, which are also called UPJ obstruction, or ureteropelvic junction obstruction. This is also can be called hydronephrosis, or “water in the kidney.”
  2. Vesicoureteral reflux, which is backwards flow of urine from the bladder back up to the kidney. This can also be treated with robotic surgery with equivalent success rates as open surgery, except that we can do this with tiny incisions instead of a large open incision.
  3. Kidney removal (complete or partial), where the kidney doesn’t appear to be working well.

After each robotic surgery, I still marvel at the technology, since we are performing these delicate surgical procedures inside the body but without making the usual larger incisions to get to the surgical area, such as the kidney. We are able to perform delicate surgical maneuvers with unmatched precision with the use of the robot, and this is especially for surgeries in children where we have small parts to work with.

Robotics improves upon the more traditional laparoscopic surgery, in which surgeons use handheld instruments passed through small incisions and view flat images of the patient’s anatomy on a standard video monitor. With robotic surgery, we have the advantages of higher precision and dexterity and high-resolution 3D images of the surgical field that are magnified to 10 times what the human eye can see.

The robotic system translates all of my hand, wrist and finger motions into the movement of surgical instruments, since I have full control of the robotic arms. It feels as if I’m operating with my own hands, and hence we are able to have greater surgical precision and decreased chance of human error.

Robotic surgery does represent the latest generation of laparoscopic surgery, and continues to be a good choice for pediatric patients due to its benefits and minimal side effects.

This is an expensive machine, and thanks to the generosity of supporters of Texas Children’s Hospital and the hospital administration, we were able to bring the robot to the Texas Children’s Hospital this past summer. With our experienced team, our patients have been getting robotic surgery for their surgeries, and usually going home the next day after surgery.

If you would like more information, please visit our webpage or watch the video above.

About Dr. Chester Koh, Pediatric Robotic Surgery Program

I am a pediatric urologist and the Director of the Pediatric Robotic Surgery Program in the Division of Pediatric Urology and the Department of Surgery at Texas Children’s Hospital and Baylor College of Medicine. I have performed hundreds of surgeries using the da Vinci surgical robot from Intuitive Surgical. My research interests include robotic and minimally invasive surgery, pediatric medical device development, and bladder development and regeneration.
Posted in Kidney Disorders, Surgery, Videos

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