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program in 2011 with the purchase of the da Vinci Si Surgical System. Volumes have grown by 30 to 40 percent each year since then, and in October, the Health System purchased a second device, the da Vinci Xi with dual consoles for training, new instrument arm architecture for better anatomical access, longer instrument shafts and a greater range of motion with smaller arms. Ten surgical specialties have been using the devices, including general surgery, colorectal, gynecology, gynecology-oncology, urogynecology, surgical oncology, thoracic, transplant, urology and otolaryngology. "Adoption of robotics largely came from the surgeons who, once they got in the console and started doing the surgery, just said to themselves, this is better. I can see better, I can dissect better, I control my own camera," says Kent Van Sickle, MD, Chief of the Division of General and Minimally Invasive Surgery at UT Health San Antonio. "You have higher degrees of freedom and much more range of motion." At an academic center such as University Health System, surgeons not only train other surgeons on robotic procedures, they a lso are pushing the envelope — expanding the kinds Kent Van Sickle, MD, Chief of the Division of General and Minimally Invasive Surgery at UT Health San Antonio UNIVERSITY HEALTH SYSTEM'S Robotic Surgery Programs PHYSiCiAN E XPERTS FROM UT HE ALTH SAN ANTONiO COME TOGE THER iN ONE PL ACE TO OFFER BOTH ROUTiNE AND COMPLE X ROBOTiC SURGERiES iN A WiDE R ANGE OF SURGiCAL SPECiALTiES. N O L O N G E R C A N robotic surger y be described as a fledgling technology. Some robotic procedures have more than two decades of accumulated data regarding outcomes. Surgeons who embrace robotic surgery cite the pinpoint precision that robotic surgery allows, the three-dimen- sional views of the surgical field and the greater flexibility of the instruments to work on hard-to-reach places in the body. For patients, "the biggest appeal is that it 's minima lly inva sive," says Georg ia McCa n n, M D, A ssist a nt Professor of Obstetrics and Gynecology at UT Health Sa n A nton io, who cha i rs t he Robotic Surgery Committee at University Hospital. "Minimally invasive procedures are associ- ated with less blood loss, less perioperative complications, less risk of infection and fa ster recover y. It gets people back to work faster." And while robotic procedures can be technica lly cha llenging, they of ten are less physica lly dema nding on the sur- geon — reducing fatigue over long, complex procedures and even the slightest tremor that fatigue can bring. University Health System established its robotic surger y BY DONALD FINLEY 0 6 0 6❱❱❱❱❱ C O V E R F E A T U R E