M. Brian Harkins, MD, FACS | 31 January 2016 | Issue 2
General Surgery…The Fastest Growing Specialty in Robotic Surgical Procedures!
Tomball leads the way in the Greater Houston Area
Tomball Regional Medical Center has become the first hospital in the Greater Houston Area to have two of the latest Da Vinci Xi robotic surgical systems in use. This doubles patient access to this highly sophisticated platform compared to other local hospitals. Dr. Harkins continues to be the most prolific user of this advanced technology. He is able to perform increasing numbers of more complex surgical cases. The winners…patients who are receiving state-of-the art care from a leading expert without the need to travel out of the area.
Incisional Hernia Repair—Why the Robotic platform is Unparalleled in Performing Ventral Hernia Repair
The repair of an incisional or ventral hernia using an open technique requires a large incision with all of the pain and recovery delays that go with that but the approach allows for more options to close the defect. Using laparoscopy results in less pain and a quicker recovery but most laparoscopists don’t close the defect. A mesh is placed and bridged across the defect and then it is usually tacked into place. This leads to higher event ration rates and increased recurrences. Each approach has advantages, but also significant disadvantages.
The robotic platform solves the problem! It is a minimally invasive platform which gives the patients the benefit of smaller incisions, less pain, and a quicker recovery. With the incredible 3D HD magnified view and wristed instrument dexterity, closing the defect and suturing in the mesh is even easier than doing this in an open approach. The result is a platform that has the best of both of the previous approaches without the downsides. So, the problem must be the cost right?…Wrong, many major studies are showing not just similar costs to laparoscopy, but decreased costs when using the robotic approach. Dr. Harkins stated, “For many years I have done open and laparoscopic repairs. Since I began using the robotic approach over a year ago I can comfortably say that I am now doing the absolute best incisional/ventral hernia repair I have ever done!”
Fastest Growing Procedure in Robotics
Incisional/ventral hernia repairs using the robotic platform represent the fastest growing procedures in robotics. With nearly 200% year over year growth since 2012, the procedure is on its way to becoming the new standard of care. More than 17,000 incisional/ventral hernias were done in 2015. Many of the most renowned leaders in hernia repair surgery have shown enthusiastic support. Dr. Harkins has vast experience with this approach using the Da Vinci Xi system!
Dr. Harkins Speaks as Surgeon Expert in Las Vegas M. Brian Harkins, MD, FACS
The “All-In” adoption of the robotic platform has “quickly” caused Dr. Harkins to be recognized as a leader in General Surgery in overall experience using the Da Vinci Xi system. Because of his success he was recently invited to be one of only 6 surgeons to attend the Intuitive Surgical World Wide Meeting. He spoke as a surgeon expert to help improve the knowledge of the attendees and to help them understand the literature, the medical and surgical facts, and the perceptions and interactions from the surgeon’s viewpoint. While he happily fielded questions from all areas he specifically focused on incisional and ventral hernias when interacting with the over 1200 attendees at the Bellagio Hotel in Las Vegas, Nevada.
He found the 4 day event invigorating and re-energizing. He stated, “It was incredibly exciting to be involved with the company that is providing the technology to take the practice of surgery to unprecedented levels of quality, precision, and improvement in patient care!”
Dr. Harkins is recognized as a world leader in experience using the Da Vinci Xi system in General Surgery.
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.
M. Brian Harkins, MD, FACS | 30 August 2015 | Volume 1, Issue 1
Know the Facts!
Your Patients Will Be Asking!
Robotic-Assisted Laparoscopy… An Evolving Standard in Minimally Invasive Surgery
Its too expensive! Its adding technology without adding benefit! It will never last!…Robotic Surgery? No! Those were pushback comments in the early 1990’s about the introduction of laparoscopy into the world of surgery. Improved patient outcomes rolled right over those objections to create a new standard in many surgical procedures. But if we recognize that minimally invasive surgery is better for patients, then after 30 years of laparoscopy, why isn’t every procedure being done that way? The short answer…some procedures were just too “hard”. Laparoscopy had limitations that kept it from completely replacing open surgery altogether.
Enter Robotic-Assisted Laparoscopy!! With the addition of a highly sophisticated robotic interface, many of the limitations of laparoscopy have been overcome making the benefits of minimally invasive surgery accessible to greater numbers of patients for many more procedures. The end result is an evolving trend of better pa-
tient outcomes in terms of lengths of stay, complications, post-operative pain, blood loss, and readmissions. Wow! The long awaited upgrade for laparoscopy is finally here!…and its available right here in Tomball!!
Safety, Experience, New Horizons
Little did I know when I did my first robotic case on 29 September 2014 that by the end of my first year I would be the second most experienced general surgeon in performing cases with the Da Vinci Xi system in the world, but that’s what has happened! I already have many personal examples of patients who would have likely undergone an open procedure if it weren’t for the robotic platform. The vast majority of these patients have enjoyed the benefits as complication rates have remained low when compared to the previous year. I wish I could say that low meant zero, but that’s just not the reality with surgery and medicine. However, I do have great hope that in the robotic platform I now have the tools and ability to move even closer to that zero complication rate threshold.
In my efforts as the Robotics Chairman of the Department of Surgery I have continued to focus the program on patient safety and staff education. TRMC Administration and Surgical Services have responded in establishing us as the only robotic program in Houston with 24/7 full access to accomplish surgeries on the robot. The evolving standard is always available here!
I am very excited to be on the forefront of this new horizon in general surgery and will continue to offer your patients the most advanced surgical care available. Best of all, they can get that care right here in Tomball.
A Brief History of the DaVinci Robot M. Brian Harkins, MD, FACS
Intuitive Surgical Incorporated’s first robot was developed in 1997 but the system did not get FDA approval until the year 2000. Improvements over the original resulted in the Da Vinci S release in 2006. In 2009 the DaVinci Si platform furthered propelled the success of the robotic surgery movement with ongoing transition of prostate surgery and malignant gynecological surgery to being almost completely done with the robotic platform. The advanced technology additions to the DaVinci Si platform began to show promise in the adoption by general and colon and rectal surgical specialties. The “game changer” as many surgeons refer to it, was the release of the Da Vinci Xi platform in 2014.
Our first robot at TRMC was the early model DaVinci S which we obtained in 2012. We traded that in for our new DaVinci Xi, the second one to arrive here in the Houston area, in July 2014. The rest, as they say, is history…in the making!!!