Issue link: https://viewer.e-digitaledition.com/i/1482519
four-arm robotics system, was released in 2014, Dr. Cooper says it was a game changer compared to laparoscopic surgeries. "The robotic-assisted technology provided patients with a less invasive surgical experience, and made it more com- fortable for surgeons," Dr. Cooper says, citing the physical challenges surgeons have when working on patients with an elevated body mass index (BMI). The da Vinci XI allows Drs. Cooper and DeSimone to perform bariatric procedures in ways they could not do laparoscopically. " We didn't think we could improve upon laparoscopic surgery, but the data we have collected has shown that robotic surgery is an excellent option for our patients," Dr. Cooper says. Incision sizes with the robot are similar to laparoscopic incisions, but patients recover faster and have shorter hospital stays. In addition, robotic-assisted surgery significantly reduces the need for postoperative narcotics among bariatric surgery patients, who are able to return to work faster with fewer incision issues requiring wound care. "We were a Center of Excellence three times over before robotics, so we didn't think we could improve on our excellent outcomes, but we did," Dr. Cooper says. Surgeons have greater control with the da Vinci XI tech- nology, allowing them to toggle between the four arms, which include surgical instruments and a camera. "You can see detail you couldn't see otherwise," Dr. Cooper says. "That allows us to visualize much more clearly, especially in patients with a large amount of intra-abdominal tissue." The robotic instruments can be rotated like a human wrist in multiple planes, allowing surgeons to operate in tight spaces and use both hands with complete dexterity. The instruments themselves are high-tech and smaller in size, which reduces the potential for complications and bleeding. The technology allows surgeons to perform procedures faster and with more efficiency. "Anything that is an advantage for me as a surgeon is going to translate into an improvement for our patients," says Dr. DeSimone. Introducing robotics technology into the operating room has changed the skill set needed for the surgical team. Every member of the team must be able to prepare for next steps before the surgeon performs them, streamlining the entire process. Dr. DeSimone refers to this process as a highly choreographed dance. Highly-skilled personnel that possess the knowledge of the robotic platform and equipment are essential to ensuring a case is completed quickly and efficiently. "We heavily rely on other individuals to do their part so we can provide the safest care for our patients. It is truly a team approach and we are very efficient with the use of our time," says Dr. DeSimone. Urology surgeon Po Lam, MD, performs prostatectomies using the da Vinci SP (Single Port) robot, which has a single arm, or port. Originally, the SP unit was mostly utilized by teaching hospitals to refine surgical techniques done with multiport systems. The Robotic-Assisted Surgeons at Crouse Hospital SURGEON SPECIALTY Kenneth Cooper, MD Jeffrey DeSimone, MD Taewan Kim, MD Bariatric James Berry, MD David Nesbitt, MD John Nicholson, MD Colorectal Michael Archer, MD Mark Crye, MD Jason Wallen, MD Cardiopulmonary Thoracic Akbar Ahmed, MD Benjamin Sadowitz, MD James Sartori, MD General David Albala, MD Po Lam, MD Hadley Narins, MD Nedim Ruhotina, MD Harvey Sauer, MD Urology Stephen Brown, MD Nikole Bucsek, MD Catherine Fiori, MD Myron Luthringer, MD Navpriya Oberoi, MD Byuong Ryu, MD Gynecology Rinki Agarwal, MD Douglas Bunn, MD Mary Cunningham, MD Allison Roy, MD OB/GYN Oncology Po Lam, MD, (left) and team M D N E W S . C O M /// M D N E W S C E N T R A L N E W Y O R K n 2 0 2 2 1 5