Embracing the future: Sentara adds new robotic technology

Published 5:41 pm Tuesday, August 15, 2023

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Sentara Obici is embracing the future with their latest medical technology addition. The hospital recently purchased the Da Vinci robotic surgical system from medical robotics company Intuitive Surgical, Inc. and aims to provide more minimal invasive surgery options for patients. As one of the three surgeons using the technology, Sentara Obici Medical Director of Bariatric Surgery Gregory F. Adams, M.D. presented the Da Vinci Xi System while describing how he uses it to perform surgical procedures.

“I’m doing the operation, but by doing that operation through the robot, it allows us better visualization, potentially less patient pain because of the way the robot works on the abdominal wall and it allows us access to areas of the body that are harder to get to…” Adams explained.

A surgeon for 30 years, Adams started his training back in 1993 while starting bariatric surgery in 2002. With many years of using traditional laparoscopy, Adams had to go through a process of conversion to use the latest technology. Thanks to advice from colleagues who had converted over, he was able to take on the process which included training classes with the robot involving a simulator system and eight hour per day online training courses with a proctor and surgeon from Intuitive Surgical, Inc. Afterward, Adams took on his first cases alongside a company proctor and the rest was history.

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Adams provided a detailed look at the Da Vinci Xi System. While it is positioned like a boom or an overhead light that you’d find at the dentist, there are four operating arms (labeled 1, 3 and 4 with 2 being the camera) that are controlled by Adams and his fellow surgeons via the control panel. This control panel console functions as the main operating desk where Adams sits. Here he uses a 3D-stereoscopic lens, fingertip-based hand controls and floor pedals that both control the operating arms, and a touchpad that highlights which arms are active. Likewise, the console locks itself once the user pulls their head out of the stereoscopic lens to keep the machine safely inactive. Adams commended Intuitive for the creation of the Da Vinci surgical system.

“They have really done a wonderful job with this machine,” Adams said. “What Intuitive has done is they built a platform that allows the surgeon to do the things that the surgeon needs to do, with a smaller learning curve, with great reproducibility and it allows them to access areas that have always been hard for us to access – especially without cutting open a great big cut.”

Adams also noted how the system provides benefits to surgeons as well. Adams expressed how laparoscopy can cause a lot of pain during long hour operations.

“It’s not like we’re busting rocks, but it’s a physically taxing day. Most of everybody when they leave the operating room, they have sweat on their hats. And it is the nature of what we do…” he said. “The reason I wanted to transition to robotics is because I don’t want to quit being a surgeon anytime soon and this will allow me to do it longer.”

When asked about the future, Adams seemed certain of the inclusion of the technology.

“The next generation is already being trained on this technology. So where health systems are having to catch up is they have to understand that the next generation will use this,” he emphasized. 

Despite the term “robot”, the presentation presented an important aspect that should put people at ease: human control. With robotics technology and even new AI technology coming into play in today’s world, people might be worried about what to expect from this new addition to Sentara Obici. Adams however, expressed that there’s nothing for residents to be worried about.

“The instrument is built so that when the surgeon does not have his eyes on the field – literally – and his hands in a safe position on the machine, the machine locks in place. Its defaults are to freeze, to be still. I think that the safety protocols that they put in place are exactly right,” Adams said.

Likewise, he detailed that while the system is new at Obici, it’s not new overall and has had 20 years of development by Intuitive. 

“A lot of times when people think about technology, they think “new.” They think “unproven.” And what I would say is, this is a proven device,” he said. “This system is not its first iteration, this is not 1.0. It’s been through a lot of iterations. The software programming, the mechanical programming, the ways that it’s built are built with redundancy in place and they’re built to keep the surgeon in control. The robot does not have the ability to take control.”

Lastly, Adams affirmed for readers that this system is not in line with the newest AI technology.

“This is not AI… This device is not at risk of being sentient,” he ended with a laugh.


Editor’s note: Updated seventh passage at 11:25 a.m., Wednesday, August 16 to reflect correct spelling.