Robotic Surgery News
Get the latest News and Updates about Dr. Brian Harkins Robotic Surgery, Case Observations, Procedures, robotic surgery procedures, and more.
Single-Site Surgery… Performing Complex Surgery Through a 1-inch Incision!
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.
Robotic Surgery – General Surgery
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!
“Fly” thru the abdominal cavity, please click here
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.
Dr. Harkins to Speak as “Surgeon Expert” in Las Vegas
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.