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OVER THE PAST DECADE, THE CROUSE INSTITUTE FOR ROBOTIC SURGERY HAS BECOME THE LARGEST MULTIDISCIPLINARY ROBOTIC SURGERY PROGRAM IN CENTRAL NEW YORK THANKS TO AN EXPERIENCED TEAM OF REGIONALLY AND NATIONALLY RECOGNIZED PHYSICIANS AND A COMMITMENT TO USING THE MOST ADVANCED, MINIMALLY INVASIVE TECHNOLOGY AVAILABLE. CROUSE HEALTH BEGAN o-ering robot- assisted surgery using the da Vinci Surgical System in August 2008. Since then, the health system has continued to set the standard for robot-assisted surgery in the region, to the benefit of both patients and providers. In 2017, Crouse robotic surgeons performed more than 1,000 procedures, more than any other area program. "Our program started back in 2008 with gynecologic oncology, and as other surgeons began noticing the benefits, we expanded into urolog y, g ynecologic, colorecta l, thoracic and general surgery," says Seth Kronenberg, MD, Chief Medical O…cer and Chief Operating Officer at Crouse. "Along the way, we supported these physi- cians by¬putting the best technology in their hands." To stay ahead of the curve in this continu- ally advancing field, Crouse has adopted each iteration of the da Vinci Surgical System. Currently, the Crouse Institute for Robotic Surgery is home to three surgical robots, including the da Vinci Si and da Vinci Xi Surgical Systems. Physicians use the da Vinci Si Surgical System to perform procedures such as single-site hysterec- tomy and cholecystectomy, while surgeons use the da Vinci Xi Surgical System — the latest generation of surgical robot — to perform more complex, multiquadrant robot-assisted surgeries. Crouse's commitment to this technology extends to adopting advanced imaging, such as using Firefly Fluorescence Imaging, to improve the precision and customization of robot-assisted procedures. This system is compatible with the da Vinci Xi Surgical System and allows for better navigation around key anatomical landmarks, such as blood vessels and lymph nodes, further enhancing the information surgeons have while performing procedures and helping improve patient outcomes. A NEW STANDARD OF UROLOGICAL CARE Research continues to illuminate the ben- efits of robot-assisted surgery. Outcomes are similar to those following open surgery, but because robotic surgery is less invasive, patients benefit from less trauma and shorter hospitalizations and less pain- ful recoveries. Compared to conventional laparoscopy, procedures completed using the surgical robot feature severa l t e ch nolog ic a l en ha ncements, including 3-D, high- def inition v isua lization, EndoWrist instrumentation that is modeled after the human wrist and enhances dexterity, and adjustable console settings that lead to a more ergonomic surgical experience. A s a resu lt , t he surgeries a re ea sier t o¬ per for m , a l low i n g phy sicia n s t o expand¬patient candidacy for minimally invasive surgery. The Crouse urolog y tea m uses the surgica l robot to perform a variety of procedures, including prostatectomy, partia l nephrectomy, pyeloplasty and radical cystectomy. According to David Albala, MD, Chief of Urology at Crouse, the robot-assisted approach has become the standard of care during prostatec- tomy and is quickly becoming standard of care during cystectomy. "Prostatectomy was the first robotic procedure that we did with significant volume, and over the years, we've modified the technique and have become much more adept at using the robot," Dr. Albala says. "It really depends on the skill of the surgeon, but I believe almost all patients are candi- dates for the robot-assisted approach." Prior to the development of the surgical robot, minimally invasive prostatectomy was di…cult to perform because the lapa- roscopic equipment lacked the wristed instrumentation found on the surgi- cal robot. "Laparoscopic prostatectomy never became popular among community urolo- g ists, prima ri ly because sew ing the urethra to the bladder was very di…cult to master," Dr. A lba la says. "There's a learning curve with the robot, but techni- ca lly, robotic prostatectomy is a much easier operation to perform." UPDATES IN GYNECOLOGIC ONCOLOGY The most common robotic procedure Crouse gynecologic oncologists perform David Albala, MD, utilizing the robotic surgical system at Crouse. Robotic Surgery Advancement BY TIFFANY PARNELL Celebrating a Decade of 1 0 1 0❱❱❱❱❱ S P E C I A L F E A T U R E