UC Davis Health

Bahareh Nejad

Technology in its many forms is having a profound impact on the worlds of medicine and health, and robotic-assisted surgery is certainly one of the biggest areas of technological improvement.

UC Davis Health surgeons have been at the forefront of defining and refining the best uses for robotic surgery in patient care since 2002. Today, we are among the nation’s leaders in this field.

Most recently, our team was among the first on the West Coast to use two of the newest robotic surgery systems: One that makes just a single incision, and another designed for spine surgery.

Overall, we have more than 20 highly-trained surgeons and skilled teams who use robotic systems for procedures ranging from prostatectomies to tonsillectomies. As an ob/gyn, I often use these systems for endometriosis treatment, hysterectomies and benign fibroid removal.

Robotic-assisted surgery gives surgeons a precision tool that requires fewer and smaller incisions to perform minimally-invasive procedures, which generally reduces scarring, hospital stays, blood loss, infection rates, use of pain medications and recovery times for patients. These systems greatly expand what surgeons can see and what they can access during challenging procedures that involve complex body structures or tight spaces.

Academic medical centers like mine have a responsibility to lead the way with new techniques, new technologies and new approaches as the field of medicine evolves — and to train the next generation of surgical specialists to use them as well. All hospitals, academic or not, with robotic-surgery programs have an obligation to establish guidelines for optimal and appropriate use of the technology. Here are some of ours:

1. Budget to keep upgrading robotics systems. As these technologies improve, so should your investment in them. Also make sure your clinical engineering team is well prepared for those upgrades.

2. Establish a robust training program, incorporating instruction from the manufacturer, mentorship from surgeon- leaders, and education for whole teams in the operating room environment. UC Davis Health has a simulation facility dedicated to providing training on new healthcare technologies, including robotics.

3. Look for ways to reduce wasteful spending. For instance, instead of having standard equipment trays for all robotics procedures, we use equipment trays specific to each procedure, saving thousands of dollars on each case. We are currently looking into the feasibility of all peel-pack, no-tray procedures, which would save even more.

4. Continuously track and report outcomes within surgical specialties to help define best practices for minimally invasive procedures.

5. For all procedures, including those with long-term robotics track records, talk with patients about the known risks and benefits, and give them options for traditional surgical approaches.

6. Establish a committee of surgeons, clinical engineers and administrators to oversee robotics system training, scheduling and utilization. The most cost-effective robotics systems are those that are being maximally used.

The ultimate mission of robotics surgery is, of course, safe and excellent patient care. I believe living up to that mission means giving patients options for minimally invasive procedures whenever possible. In doing so, we keep moving forward toward the best possible care for patients everywhere.