Robotic surgery implemented in cardiothoracic and colorectal procedures is now a reality on the Island.
Dr. Alberto Maldonado Molina, cardiothoracic surgeon and specialist in surgical procedures at Hospital Damas. Photomontage: Medicine and Public Health Magazine.
Although robotic technology for surgical procedures began to be implemented several years ago in Puerto Rico through the well-known Da Vinci platform, this innovation was not available for other specialties such as surgery cardiothoracic and colorectal.
Its use was limited to gynecological procedures, surgery general and urological interventions. Currently, Hospital Damas in Ponce uses this platform developed specifically for patients with conditions of the lung, esophagus, and thoracic cavity.
Robotic technology for pulmonary procedures in Puerto Rico
The pioneer specialist in bringing this technology to the Island is Dr. Alberto Maldonado Molina, a cardiothoracic surgeon and specialist in surgical procedures at Hospital Damas, who successfully carried out, in December of the previous year, the first robotic lung biopsy in Puerto Rico, an unprecedented milestone in the country’s medicine.
“I have been in the United States since 2013 practicing surgery cardiothoracic and cardiovascular and I have always been interested in surgery robotics. One of the dreams that she had was to return to the Island and bring that technology to the Island that does not exist in Puerto Rico, it exists for other specialties, but not for surgery thoracic ”, mentioned the expert.
Among the advantages of this technological innovation, the specialist highlights that it allows remote operation of the patient, that is, the doctor in charge operates the Da Vinci robot in the same operating room from an external monitor. This provides greater precision in the incisions that are made, in addition to providing a minimally invasive intervention.
“That makes an incredible difference in patient recovery, pain and hospital stay. I’ve been doing this surgery since 2013 and patients go home faster, without major complications, they see each other in the office in a week and then they can resume their daily work, with a surgery it cannot be done openly”, emphasized Dr. Maldonado.
Minimally invasive interventions and with greater precision, a benefit for patients
At the Damas Hospital the surgery Robotics is currently used throughout the field of surgery cardiac and thoracic, however, the main priority is the care of patients suffering from cancer of the lung, esophagus, or in the thoracic cavity, acknowledged the doctor.
In this regard, the specialist delved into the services that can be provided with this state-of-the-art technology. “It is used for lung lesions, lung cancer, lymph node diseases in the thorax, esophageal cancer and other procedures that are not malignant lesions in the esophagus,” he pointed out.
In addition, he added that “it is also used for lesions in the mediastinum, which is a compartment of the thoracic cavity where tumors can arise and Da Vinci technology can be used to resect those tumors without having to open the thorax, that provides much more comfort for the patient, less pain, faster recovery, less expense for the hospital and less incidence of bleeding”.
This type of technology has been practiced in the United States for years and for specialists the surgery Robotics has shown favorable results in the recovery of patients, although as in any surgical modality, there are risks.
“It should be noted that there was a minimally invasive way to perform these procedures, which was the surgery thoracoscopic, with a pair of rotaries, but it does not offer the versatility that the robot offers when it allows a wide field and with more movement of the robot arms. This provides better results than both operations: thoracoscopy and open”, highlighted Dr. Maldonado.
The specialist also explained that in the particular case of a patient who has lung cancer or a possibly cancerous lesion in the lung, at the Damas Hospital they have recently developed technologies, apart from Da Vinci, to intervene.
“We are going to be the first of all the places in Latin America that is going to have this technology called VEGAN that allows us, guided by CT, to locate a lesion in the thorax, perform a percutaneous biopsy guided by the robot and following marking the lesion , one enters with four small incisions; some accesses are introduced so that the arms of the robot can be coupled and the operator, in this case I, operate from a console”.
Patients can be diagnosed and treated using robotic technology
Before operating on a cancer patient, evaluation protocols are carried out to determine if the lesion is robotically resectable, or if the patient has associated comorbidities or cardiac risk.
In addition to that, quality control and periodic reviews of each of the operators are implemented to ensure compliance with the robot’s parameters.
One of the most relevant advantages of this technology is that it allows the patient to be diagnosed and treated in the same specialized site, as well as improving their recovery time.
“If the patient has a malignant lesion, he can start the chemotherapy or adjuvant therapy that he requires, earlier than with the surgery conventional,” he said.
Apart from that, the specialist recognizes that the use of robotic technology is also a benefit for medical plans and hospitals, because the required costs are lower and medical plans cover these procedures.
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