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!!!
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.”