Cleveland Clinic first in U.S. to use single-incision robotic surgery

Urologic surgeons at the Cleveland Clinic are the first in the country to successfully perform prostate surgery using a new generation of robot that inserts surgical instruments through a small incision.

Surgeons used the Single Port SP Robot from Intuitive Surgical to remove cancerous prostates as well as an enlarged prostate blocking the urinary system through the bladder.

Jihad Kaouk, MD, director of the Cleveland Clinic’s Center for Robotic and Image Guided Surgery in the Glickman Urologic and Kidney Institute, contends that the ability to enter the body through a single, small incision helps surgeons perform more complex procedures while improving surgical outcomes and allowing quicker patient recovery.

“We anticipate that this new generation of robots will allow for new and different routes of surgeries that haven’t previously been possible,” says Kaouk, who is a paid consultant, speaker or member of the advisory committee for Intuitive. “For example, we can now go through a patient’s perineum instead of their belly to perform prostate surgery and avoid touching the bowel, or work through the retroperitoneal space to perform kidney surgery without entering the abdomen, allowing for quicker recovery time.”

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Kaouk emphasizes that the robot is not programmed to perform surgery on its own automatically. Instead, he notes that the procedure is completely performed by the surgeon who directs the system through a joystick at a console that includes high-definition 3D vision, a magnified view, and robotic and computer assistance.

“It’s an extension of the surgeon’s hands, fingers and eyes,” Kaouk says. “The incision is made by the surgeon and then through that incision we introduce a multi-channel port—and it is via the port that robotic instruments go through.”

According to Kaouk, who performed the first U.S. surgery, the Single Port SP Robot is currently approved by the Food and Drug Administration for urologic surgeries including radical prostatectomy, pyeloplasty, nephrectomy and partial nephrectomy, with plans to expand to ear, nose and throat (ENT) and colorectal surgeries in the near future.

“ENT surgeons could use it for surgery through the mouth without needing cuts in the neck from outside to get to the deep throat, for example, or the base of the tongue,” he adds.

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