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Another First for Tomball Regional Medical Center

As proven leaders in robotic surgery, Tomball Regional Medical Center and Dr. Brian Harkins has accomplished yet another milestone!!! Single-Site surgery on the Da Vinci Xi robot premiered at TRMC on May 4, 2016. Dr. Harkins accomplished the first Single-Site cholecystectomy on the Xi in Houston… in Texas… and one of the first ten in the country.

The FDA recently released approval for the technology to be applied to the Xi platform which allows gallbladder surgery to be done through a single one-inch incision at the umbilicus. Currently, the approved surgeries are Cholecystectomy, Oophorectomy, and Hysterectomy. As experience grows and technological advances continue, expect more and more surgery to be done through ever decreasing incisions!

While one could expect to pay a premium for this state of the art technology the reality is that the cost is ever less than the robotic multiport equivalent. Dr. Harkins is currently seeking patients to assess if they are candidates for Single-Site on the DaVinci Xi. In fact, as of press time for this newsletter, it’s the only place you can get in Houston!

Houston Technology Turns Hard to Easy… and Safe

Some of you may recognize the term Single Site or Single Port. The concerted effort to introduce this approach into laparoscopy began in 2007. Studies proved it safe and effective. The increased degree of difficulty in doing the operation, however, resulted in limited penetration into the field of surgery.
Placing 3 instruments and a camera through once trocar and trying to find enough room to manipulate all of that in close quarters was challenging at best. Not to mention that the limited working room required the instrument on the left of the screen and visa-verse for the other hand. It was kind of like operating looking into a mirror while playing Twister! No wonder it didn’t catch on as expected. But if you connect all the instrument to the robotic platform then Presto… hard becomes easy.

The robot is designed to manage the tight quarters and the computer adjusts the view for the unnatural angles and visual associations. The older model DaVinci Si was the first robotic platform to have this but many surgeons had limited access to a robot making that the rate limiting step for adoption. Robots are increasingly more available and general surgeons are quickly adopting the platform. Couple this with added safety in identifying the ductal anatomy using Firefly visualization (see side panel) and it’s easy to see how the future of minimally invasive surgery is the header in “1” direction. 1 incision, 1 inch long equals 1 happy patient!

“Fly” thru the abdominal cavity, please click here 

Dr. Harkins Guest Lectures in Minneapolis

“One of the aspects I like the most about being on the cutting edge of technology in surgery is the ability to interact with colleagues across the country as the surgical community helps to shape this emerging standard” stated Dr. Brian Harkins in a recent lecture to surgeon colleagues in Minneapolis, Minnesota. He pointed out that the surgical community has seen this happen before.
The early 1990’s saw the emergence of laparoscopy as a standard practice in general surgery. Most laparoscopy prior to that was performed by gynecology. In less than a decade, laparoscopy became a gold standard in many procedures and general surgeons became the most prolific laparoscopists.
While urology and gynecology have lead the way in robotics since 2000, it’s the new advanced technologies and latest robotic platform, the Xi, that have opened the door for general surgery to perform an increasing number of complex multi-quadrant procedures. He concluded, “This is paving the way for robotic surgery to be the new minimally invasive standard in general surgery. You could say, its laparoscopy with a long overdue upgrade to advance technology!”

Dr. Harkins is recognized as a world leader in experience using the Da Vinci Xi system in General Surgery.

Download Newsletter Issue #3 [PDF]

Las Vegas Nevada is the site for this year’s Worldwide Sales Meeting for Intuitive Surgical, the maker of the Da Vinci Xi Robotic Surgical System. Dr. Brian Harkins is one of a select group of surgeons who has been invited to be in attendance as a “Surgeon Expert” to help educate and provide the surgeon’s perspective to the attendees. His focus at this meeting will be his experience and knowledge regarding the robotic surgical system to accomplish hernia repairs. Across the country and worldwide the robotic surgical system, an advanced minimally invasive platform, is demonstrating rapid growth and acceptance in many areas to include ventral, incisional, and inguinal hernias. As a leader in experience using the Da Vinci Xi, Dr. Brian Harkins is proud to offer this state-of-the-art surgical care. In his over 20 years of practice in Northwest Houston he has cared for patients who have sought him out from across the United States and abroad.

A new robotic-assisted surgical system is paving the way for improved patient outcome statistics at the Tomball Regional Medical Center.

TRMC purchased and implemented the new robotic surgical platform in 2014. Dr. Brian Harkins, a surgeon at Tomball Regional Medical Center, said he has carried out the second highest number of general surgery cases using the new robotic platform of all surgeons in the world.

Dr. Harkins spoke at the Greater Tomball Area Chamber of Commerce luncheon Aug. 7 about the benefits and drawbacks of using robotic technology in surgery

“The robot doesn’t do surgery any more than a scalpel or hemostat does surgery,” Dr. Harkins said. “It has to be manipulated by a surgeon. This is the way the system is set up, and it doesn’t actually do anything on its own.”

During a robotic surgical procedure, a surgeon is seated at a console with an armrest and headrest and can control the precise movements of the robot with his hands, Dr. Harkins said.

The robotic technology allows for improvements in dexterity with “wristed” instruments, ergonomics of hand motions, 3-D vision and an increased possibility of single-incision surgeries, Dr. Harkins said.

“In this case where the surgeon is sewing, instead of reaching way out to do all of that, it’s right here in front of you,” Dr. Harkins said. “You see it in front of you and move your hands in a very simple motion.”

A significant portion of procedures traditionally carried out by open surgeries that may require multiple large incisions are now being conducted with the robotic platform, such as hysterectomies and prostatectomies, Dr. Harkins said.

However, one of the drawbacks of the robotic surgical platform is its financial cost, Dr. Harkins said. When first implemented several decades ago, laparoscopic surgery was a more costly option for hospitals, and now it is recognized as a standard for many procedures, he said.

The robotic surgical platform is the most advanced technique available for abdominal surgery, Dr. Harkins said.

“In the robotic world, it’s always crystal clear and magnified, and you are fully in the picture,” Dr. Harkins said. “Precision and complete control of the instrument makes a difference over time. Technology allows you to have better information in the operating room, which should lead to better decisions and better outcomes.”

TRMC plans to continue improving recovery times for patients and reduce surgical complications with the robotic platform, Dr. Harkins noted. With more funding, TRMC seeks to upgrade and implement a newer model of the robotic platform with additional surgical capabilities in the near future, he said.

“This is the current revolution in minimally-invasive surgery,” Harkins said. “It is a long awaited upgrade for laparoscopy and something we needed for awhile. I’m going to continue offering my patients at Tomball Regional Medical Center the best, the safest and most advanced care possible using the robotic platform.”

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