This is very simple. I hope to go into remission and be able to return to work and go on with life and put this behind me. I understand that I have stage 4 cancer and will most likely be on some form of chemo therapy for the rest of my life. What I hope for is a treatment that allows me to work and live on my own and just let’s me get on with life. If that is not possible, I would like to get to a point where surgery is possible. At the moment the spots on my liver are not localized so that makes surgery impossible. But if we can get rid of some of the spots completely where there are only some on one side then a surgeon can go in and cut that part out. The cool thing about your liver is it can grow back. I have been told that they can take 80% of your liver and within 6 weeks it will mostly have grown back!
For now I just keep doing as my doctor tells me and go to treatment every two weeks. Living 2 months at a time in hopes for good results in which I can still go on with treatment and live as regular a life as possible. I am not prepared to ever give up and I believe the mentality you have about living with cancer can help sustain you. The more optimistic you are the more it feels like going through all this treatment will be worth it in the end.
Friday, March 18, 2011
Thursday, March 17, 2011
How Cancer has affected my life and the life of my family
Since I was diagnosed the biggest change has been the loss of my independence. Once I started my chemo treatment I was not sure whether I could handle it while living on my own so I moved back home. Being almost 30 and living at home was definitely not what I had ever envisioned for my life. It isn’t all bad because I have no rent; groceries and cable are paid for so those are bonuses. But if I had my choice I would still be out on my own. Since I have been in treatment for over a year now I know I can handle my treatments and do everything I need to do to survive so I am planning on moving out again in the fall, which I can’t wait for. I think that will make me feel like a more normal 30 year old woman.
The second biggest change is that I have not worked since November 2009. I am now on disability. Which I guess is an extension of losing my independence. This is another thing in my life I never thought I would have to do. Relying on an insurance company for my living is not exactly what I want. I always enjoyed working and miss it a lot. I hope one day I can return. If only to make me feel like a normal 30 year old. Someone my age should not be on disability. I should be out there contributing my part to society. But instead I spend most my days at home waiting for my friends to get off work for something to do.
One positive thing that came out of my diagnosis is that my family has definitely become closer. Before diagnosis we mostly went on with our own lives and did not do much together. Now for the first time ever we are taking a family trip to Cape Cod this summer. I am really looking forward to it. I also feel that I and my sister have become a lot closer. Before we never had much in common but now have found some common ground and definitely fight a lot less.
One thing they don’t tell you once you are diagnosed is how boring being sick is. Your life changes drastically but in the end it stops you in your tracks and you have to go through the motions of all the doctor appointments and the treatments waiting to get your normal life back. Don’t get my wrong it is worth going through everything and keeping optimistic even in the face of not the best odds but once you are diagnosed you can’t help wanting to feel normal again
The second biggest change is that I have not worked since November 2009. I am now on disability. Which I guess is an extension of losing my independence. This is another thing in my life I never thought I would have to do. Relying on an insurance company for my living is not exactly what I want. I always enjoyed working and miss it a lot. I hope one day I can return. If only to make me feel like a normal 30 year old. Someone my age should not be on disability. I should be out there contributing my part to society. But instead I spend most my days at home waiting for my friends to get off work for something to do.
One positive thing that came out of my diagnosis is that my family has definitely become closer. Before diagnosis we mostly went on with our own lives and did not do much together. Now for the first time ever we are taking a family trip to Cape Cod this summer. I am really looking forward to it. I also feel that I and my sister have become a lot closer. Before we never had much in common but now have found some common ground and definitely fight a lot less.
One thing they don’t tell you once you are diagnosed is how boring being sick is. Your life changes drastically but in the end it stops you in your tracks and you have to go through the motions of all the doctor appointments and the treatments waiting to get your normal life back. Don’t get my wrong it is worth going through everything and keeping optimistic even in the face of not the best odds but once you are diagnosed you can’t help wanting to feel normal again
Wednesday, March 16, 2011
Warning Signs of my colon cancer
Starting at the age of 17 I had this weird gastro problem every few years. I would not be able to keep anything down for over a week every time it happened. I would lose 10lbs in a week. I would go to the doctor and they would tell me it was just a gastro virus and to eat very plain and eventually it would go away. And it always did. This happened every few years until I got really sick in the summer of 2009. It was very strange because I was never one to ever get the flu let alone a cold. But I would always get this gastro problem.
Sometimes it would be diagnosed as severe heart burn and I would be downing pepto like it was water. But it never helped. It was strange because I never really noticed any changes in the bathroom. Once I was diagnosed I was told that it was a level one cancer. Which is kind of like lazy cancer, it moves very slowly. Due to that I believe it was growing so slowly that any changes that may have happened occurred so slowly that I didn’t really notice.
I am not sure that I had colon cancer at the age of seventeen but I do know it was always the same thing. I would have severe stomach pain and vomit constantly for a week. Most of the time it was just bile because I hadn’t eaten anything at all, all week.
Looking back I can see why doctor’s would never guess it was colon cancer. But I wish I could have been more intuitive and have realized I was sick long ago so I wouldn’t be at the stage I am at where it has spread to my liver. But hindsight is 20/20 and all I can do is go forward from here and fight like hell to keep my quality of life at a point I am happy with.
Sometimes it would be diagnosed as severe heart burn and I would be downing pepto like it was water. But it never helped. It was strange because I never really noticed any changes in the bathroom. Once I was diagnosed I was told that it was a level one cancer. Which is kind of like lazy cancer, it moves very slowly. Due to that I believe it was growing so slowly that any changes that may have happened occurred so slowly that I didn’t really notice.
I am not sure that I had colon cancer at the age of seventeen but I do know it was always the same thing. I would have severe stomach pain and vomit constantly for a week. Most of the time it was just bile because I hadn’t eaten anything at all, all week.
Looking back I can see why doctor’s would never guess it was colon cancer. But I wish I could have been more intuitive and have realized I was sick long ago so I wouldn’t be at the stage I am at where it has spread to my liver. But hindsight is 20/20 and all I can do is go forward from here and fight like hell to keep my quality of life at a point I am happy with.
Tuesday, March 15, 2011
My Journey to Diagnosis
It was a long, painful journey to diagnosis for me. It started in July of 2009. I got really sick and could not keep anything down and lost about 10lbs in a week. I went to the ER and they told me I had a gastro virus and to eat toast and drink lots of water and eventually I would get better. I did begin to feel better and went back to normal life until mid August when I got a severe pain on my left side and started vomiting again. I went back to the ER and they did a CT scan. They told me I had diverticulitis and to take some antibiotics, don’t eat for three days and come back on the fourth if I am still in severe pain. Needless to say it was the longest weekend of my life. I felt miserable and I was starving. But as soon as I ate on Monday I felt a severe pain and threw it right back up. We went right back to the ER where a doctor decided to keep me there because she felt there was more going on.
I was admitted to the hospital that day and had to wait a day to get another CT scan. Once that scan was done my doctor told me I had a hole in my colon and a 5cm in diameter abscess had grown out of it. They still believed the hole was created by diverticulitis. They kept me in the hospital for two weeks on IV antibiotics which were given to me twice daily. Being in the hospital for that long in the middle the summer was a bummer. But I did have a lot of company every visiting hour that passed. I felt like a fish out of water though because I was surrounded by elderly people having hip replacements and such and I was like “what am I doing here?”
So I was finally released and went back to work a couple weeks later. I still felt sick and had a hard time eating but I was told nothing was wrong with me and it was normal not to have much of an appetite. But then the pain returned and the vomiting started again. I was calling every doctor I knew to tell them I still feel sick and was losing weight by the day. They told me that was normal so I went to work everyday and just got used to vomiting at work and then getting on with the day. Finally the day came that I could have a colonoscopy. I had to wait until November because they wanted to make sure the hole had healed.
I was five minutes into the procedure and it stopped I was wheeled out of the room and my mother was told to come in and wait with me. I was under light sedation so I didn’t have any feelings about what was to come. The doctor called us in and sat us down and showed me a picture of a large tumour he ran right into 5 minutes in. This is what broke through my colon and had caused so much pain and trouble with my digestion. He looked like he saw a ghost. It would have been comical if it wasn’t so serious. He was pretty sure at the time it was cancerous but had to do a biopsy to be sure. At the time I had spots on my liver that they contributed to the infection and didn’t think much of them. But now they were suspect and expected it to be cancer which had spread. I did not cry right away. I was almost relieved to finally find out what was causing me such pain and grief. At that time I had probably lost 40lbs and was wasting away so I figured at least now the right doctors will be assigned to me and we could get down to the business of kicking the cancer in the ass.
My cancer was confirmed a few days letter. I had surgery 3 weeks later where they took two feet of my colon while also looking at my liver to confirm that it was cancer that had spread. And that was confirmed that yes it had. It took 4 months and 50lbs before everything was made clear. I was now a cancer survivor and that title will be with me for the rest of my life.
I was admitted to the hospital that day and had to wait a day to get another CT scan. Once that scan was done my doctor told me I had a hole in my colon and a 5cm in diameter abscess had grown out of it. They still believed the hole was created by diverticulitis. They kept me in the hospital for two weeks on IV antibiotics which were given to me twice daily. Being in the hospital for that long in the middle the summer was a bummer. But I did have a lot of company every visiting hour that passed. I felt like a fish out of water though because I was surrounded by elderly people having hip replacements and such and I was like “what am I doing here?”
So I was finally released and went back to work a couple weeks later. I still felt sick and had a hard time eating but I was told nothing was wrong with me and it was normal not to have much of an appetite. But then the pain returned and the vomiting started again. I was calling every doctor I knew to tell them I still feel sick and was losing weight by the day. They told me that was normal so I went to work everyday and just got used to vomiting at work and then getting on with the day. Finally the day came that I could have a colonoscopy. I had to wait until November because they wanted to make sure the hole had healed.
I was five minutes into the procedure and it stopped I was wheeled out of the room and my mother was told to come in and wait with me. I was under light sedation so I didn’t have any feelings about what was to come. The doctor called us in and sat us down and showed me a picture of a large tumour he ran right into 5 minutes in. This is what broke through my colon and had caused so much pain and trouble with my digestion. He looked like he saw a ghost. It would have been comical if it wasn’t so serious. He was pretty sure at the time it was cancerous but had to do a biopsy to be sure. At the time I had spots on my liver that they contributed to the infection and didn’t think much of them. But now they were suspect and expected it to be cancer which had spread. I did not cry right away. I was almost relieved to finally find out what was causing me such pain and grief. At that time I had probably lost 40lbs and was wasting away so I figured at least now the right doctors will be assigned to me and we could get down to the business of kicking the cancer in the ass.
My cancer was confirmed a few days letter. I had surgery 3 weeks later where they took two feet of my colon while also looking at my liver to confirm that it was cancer that had spread. And that was confirmed that yes it had. It took 4 months and 50lbs before everything was made clear. I was now a cancer survivor and that title will be with me for the rest of my life.
Monday, March 14, 2011
The Future of Cancer and Robotic Assisted Surgery
Whether or not robotic assisted surgery is currently cost effective, the technology is here to stay. The industry has grown at an incredible rate making this technology more accessible across Canada, the United States and across the globe. For example, in 2004 less than 25,000 da Vinci surgical procedures were performed worldwide. In 2009, a mere 5 years later, there were close to 200,000 da Vinci surgical procedures. That is over a 45 percent growth .
As clinical trials are done, the da Vinci will hopefully improve in technology, accessibility, and how it is used. Clinical trials will pin point the draw backs of using the da Vinci Surgical System and provide ways in which the technology can be improved. Competition between medical institutions and hospitals to provide the most innovative procedures will increase demand for the da Vinci making its training programs more accessible to surgeons and its surgeries more available to patients, including those seeing cancer treatment. Surgical procedures will hopefully also be refined, as technological improvements will allow surgeons to perform more complex surgeries.
Just imagine what possibilities this technology could bring. With the growing speed and access to wireless networks, it is theoretically possible to use the da Vinci wirelessly over long distances. A surgeon from Vancouver could perform a da Vinci laparoscopic prostatectomy on a patient in Ottawa as long as the console (in Vancouver), and the patient side cart (in Ottawa) were connected via wireless technology. This could provide all different types of surgical opportunities as medical facilities would not necessarily need to have both the da Vinci console and patient side cart on site at the same time. This could also reduce the cost required to spend on da Vinci equipment, as hospitals may not need to invent in both the surgical console and the patient side cart.
There is really no way to know where this technology may eventually take us. But like most new technology, it is expensive and somewhat controversial. Should we continue to invest in this technology when there is a lack clinical research to show that it is cost effective? Who should be responsible for investing in this technology? Here in Canada, we are fortunate to have a universal health care system. But as taxpayers, should we be investing in technology that may not be cost effective? These are very tough questions to answer especially for hospitals, medical practitioners and policy makers.
As it stands right now, the da Vinci surgical system has the potential to provide several short term benefits for those undergoing minimally invasive surgery. This includes a number of cancer surgeries such as laparoscopic prostatectomy, laparoscopic hysterectomy and laparoscopic nephrectomy. Clinical research, all be it limited, seems to suggest that the da Vinci Surgical System can reduce blood loss and transfusion exposure during the procedure while reducing post-operative pain, recovery time and hospital stay when compared to typical laparoscopic and open surgical techniques. These advantages provide cancer patients with less invasive surgical options and alternatives to other suggested measures of treatment.
In time, as more clinical evidence is gathered, the da Vinci may offer more advantages as the technology is improved and as surgical procedures are refined. But until then, it remains a very expensive piece of technology with a tremendous amount of potential.
Robotic Assisted Surgery and Canada
As it stands right now, the da Vinci Surgical System is not as widely available in Canada as it is in other parts of the world. The following Canadian locations have access to the da Vinci Surgical System :
• St. Michael's Hospital (Toronto, ON)
• Toronto General Hospital (Toronto, ON)
• Sir Mortimer B. Davis - Jewish General Hospital (Montreal, QC)
• Hopital du Sacre-Coeur de Montreal (Montreal, QC)
• Montreal General Hospital (Montreal, QC)
• Vancouver General Hospital (Vancouver, BC)
• Royal Alexandra Hospital (Edmonton, AB)
• University of Alberta Hospital (Edmonton, AB)
• Rockyview General Hospital (Calgary, AB)
• St. Joseph's Hospital (London, ON)
• Canadian Surgical Technologies & Advanced Robotics (London, ON)
As clinical trials are done, the da Vinci will hopefully improve in technology, accessibility, and how it is used. Clinical trials will pin point the draw backs of using the da Vinci Surgical System and provide ways in which the technology can be improved. Competition between medical institutions and hospitals to provide the most innovative procedures will increase demand for the da Vinci making its training programs more accessible to surgeons and its surgeries more available to patients, including those seeing cancer treatment. Surgical procedures will hopefully also be refined, as technological improvements will allow surgeons to perform more complex surgeries.
Just imagine what possibilities this technology could bring. With the growing speed and access to wireless networks, it is theoretically possible to use the da Vinci wirelessly over long distances. A surgeon from Vancouver could perform a da Vinci laparoscopic prostatectomy on a patient in Ottawa as long as the console (in Vancouver), and the patient side cart (in Ottawa) were connected via wireless technology. This could provide all different types of surgical opportunities as medical facilities would not necessarily need to have both the da Vinci console and patient side cart on site at the same time. This could also reduce the cost required to spend on da Vinci equipment, as hospitals may not need to invent in both the surgical console and the patient side cart.
There is really no way to know where this technology may eventually take us. But like most new technology, it is expensive and somewhat controversial. Should we continue to invest in this technology when there is a lack clinical research to show that it is cost effective? Who should be responsible for investing in this technology? Here in Canada, we are fortunate to have a universal health care system. But as taxpayers, should we be investing in technology that may not be cost effective? These are very tough questions to answer especially for hospitals, medical practitioners and policy makers.
As it stands right now, the da Vinci surgical system has the potential to provide several short term benefits for those undergoing minimally invasive surgery. This includes a number of cancer surgeries such as laparoscopic prostatectomy, laparoscopic hysterectomy and laparoscopic nephrectomy. Clinical research, all be it limited, seems to suggest that the da Vinci Surgical System can reduce blood loss and transfusion exposure during the procedure while reducing post-operative pain, recovery time and hospital stay when compared to typical laparoscopic and open surgical techniques. These advantages provide cancer patients with less invasive surgical options and alternatives to other suggested measures of treatment.
In time, as more clinical evidence is gathered, the da Vinci may offer more advantages as the technology is improved and as surgical procedures are refined. But until then, it remains a very expensive piece of technology with a tremendous amount of potential.
Robotic Assisted Surgery and Canada
As it stands right now, the da Vinci Surgical System is not as widely available in Canada as it is in other parts of the world. The following Canadian locations have access to the da Vinci Surgical System :
• St. Michael's Hospital (Toronto, ON)
• Toronto General Hospital (Toronto, ON)
• Sir Mortimer B. Davis - Jewish General Hospital (Montreal, QC)
• Hopital du Sacre-Coeur de Montreal (Montreal, QC)
• Montreal General Hospital (Montreal, QC)
• Vancouver General Hospital (Vancouver, BC)
• Royal Alexandra Hospital (Edmonton, AB)
• University of Alberta Hospital (Edmonton, AB)
• Rockyview General Hospital (Calgary, AB)
• St. Joseph's Hospital (London, ON)
• Canadian Surgical Technologies & Advanced Robotics (London, ON)
Friday, March 11, 2011
Robotic Assisted Cancer Surgery: Robotic Surgery vs. Laparoscopic Surgery
As noted previously, robotic assisted surgery was developed to improve laparoscopic surgery. Laparoscopic surgery is a common surgical technique to treat several types of cancers including prostate, colon, kidney and ovarian cancers as well as cancer of the throat and esophagus. Given the ergonomic advantages of a laparoscopic surgery using the da Vinci surgical system, which technique – traditional or robotic – provides the most successful surgeries when treating cancer?
In general, robot-assisted surgery has been associated with reduced blood loss, reduced transfusion exposure, fewer complications, reduced post-operative pain, shorter hospital stays, and reduced recovery times as compared to typical laparoscopic and open surgical techniques . But, given the relatively recent introduction of robotic assisted surgery, there is a lack of substantial medical proof to substantiate these clinical benefits.
For example, according to the Canadian Agency for Drugs and Technologies in Health (CADTH), conclusions regarding the benefits of the da Vinci must be drawn carefully due to the lack of clinical research. CADTH’s literature analysis of current research measuring performance of the da Vinci surgical system for laparoscopic prostatectomy, hysterectomy and nephrectomy (common surgeries to treat prostate, cervical and kidney cancers), which is limited, showed statistically significant benefits. This included less blood loss during the procedure and shorter hospital stays after the procedure when compared to a typical laparoscopic and open prostatectomy, hysterectomy and nephrectomy. But, according to CADTH’s report, research in this area is limited making it difficult to come to any substantial conclusions . With that being said, the research that does exist suggests that some laparoscopic procedures that use the da Vinci may be less invasive and provide several short term benefits.
But what about long term benefits? According to CADTH, there are currently no long term clinical benefits to using the da Vinci. This seems to be one of da Vinci’s largest criticisms because robotic assisted surgery is costly compared to open and laparoscopic surgeries. The da Vinci costs roughly C$2.7 million with annual maintenance costs of about C$186,000. In addition, the average instrument cost per procedure is approximately C$2,600 (many of these instruments are not reusable) . The use of the da Vinci may also require additional operating room time and there is a learning curve associated with effective use the of the da Vinci surgical system – surgeons must perform 150 to 200 procedures to really become adept with the technology . Therefore, when push comes to shove, one has to wonder if it is cost effective to use the da Vinci over traditional surgical procedures. Do the benefits outweigh the costs?
Take prostate cancer as an example. A popular treatment for prostate cancer is a laparoscopic prostatectomy. A da Vinci laparoscopic prostatectomy costs (net cost) roughly six per cent more, or $1,600, not including the robot itself, than alternative procedures . Even though it is more expensive, the da Vinci laparoscopic prostatectomy may offer a less invasive surgical option. This may benefit prostate cancer patients because often times patients choose non-surgical interventions such as “watchful waiting” to avoid the consequences of surgery. But the potential for a surgical procedure that offers a faster recovery time as well as fewer complications during the procedure may encourage patients to opt for a surgical intervention using the da Vinci. The extra cost may be offset by reductions in post-operative hospital costs as patients recover more rapidly from this procedure. But this is all speculation. Time will tell if this is truly the case.
So is laparoscopic surgery using the da Vinci superior to traditional laparoscopic surgery? Preliminary research suggests it may be. But the question remains: is it worth the economic price we pay for the technology?
i Canadian Agency for Drugs and Technologies in Health. (September 28, 2010). Draft report - Robot-assisted surgery versus open surgery and laparoscopic surgery: Clinical and cost- effectiveness analyses. Accessed at http://www.cadth.ca/index.php/en/publication/2682
ii Ibid
iii Ibid
iv Vancouver Sun. (October 2, 2010). Meet Jack the surgical robot: He’s on the cutting edge of cancer treatment. Accessed at http://bit.ly/9f9gE0
v Ibid
vi “Watchful waiting” is a non-surgical intervention for prostate cancer. It involves a regular examination of the prostate and its PSA level. Immediate treatment (surgery or other) is only recommended if signs of cancer appear or change. Prostate cancer is not known to be an aggressive cancer. Some prostate cancers are very slow growing and can be present for years without affecting one’s health.
In general, robot-assisted surgery has been associated with reduced blood loss, reduced transfusion exposure, fewer complications, reduced post-operative pain, shorter hospital stays, and reduced recovery times as compared to typical laparoscopic and open surgical techniques . But, given the relatively recent introduction of robotic assisted surgery, there is a lack of substantial medical proof to substantiate these clinical benefits.
For example, according to the Canadian Agency for Drugs and Technologies in Health (CADTH), conclusions regarding the benefits of the da Vinci must be drawn carefully due to the lack of clinical research. CADTH’s literature analysis of current research measuring performance of the da Vinci surgical system for laparoscopic prostatectomy, hysterectomy and nephrectomy (common surgeries to treat prostate, cervical and kidney cancers), which is limited, showed statistically significant benefits. This included less blood loss during the procedure and shorter hospital stays after the procedure when compared to a typical laparoscopic and open prostatectomy, hysterectomy and nephrectomy. But, according to CADTH’s report, research in this area is limited making it difficult to come to any substantial conclusions . With that being said, the research that does exist suggests that some laparoscopic procedures that use the da Vinci may be less invasive and provide several short term benefits.
But what about long term benefits? According to CADTH, there are currently no long term clinical benefits to using the da Vinci. This seems to be one of da Vinci’s largest criticisms because robotic assisted surgery is costly compared to open and laparoscopic surgeries. The da Vinci costs roughly C$2.7 million with annual maintenance costs of about C$186,000. In addition, the average instrument cost per procedure is approximately C$2,600 (many of these instruments are not reusable) . The use of the da Vinci may also require additional operating room time and there is a learning curve associated with effective use the of the da Vinci surgical system – surgeons must perform 150 to 200 procedures to really become adept with the technology . Therefore, when push comes to shove, one has to wonder if it is cost effective to use the da Vinci over traditional surgical procedures. Do the benefits outweigh the costs?
Take prostate cancer as an example. A popular treatment for prostate cancer is a laparoscopic prostatectomy. A da Vinci laparoscopic prostatectomy costs (net cost) roughly six per cent more, or $1,600, not including the robot itself, than alternative procedures . Even though it is more expensive, the da Vinci laparoscopic prostatectomy may offer a less invasive surgical option. This may benefit prostate cancer patients because often times patients choose non-surgical interventions such as “watchful waiting” to avoid the consequences of surgery. But the potential for a surgical procedure that offers a faster recovery time as well as fewer complications during the procedure may encourage patients to opt for a surgical intervention using the da Vinci. The extra cost may be offset by reductions in post-operative hospital costs as patients recover more rapidly from this procedure. But this is all speculation. Time will tell if this is truly the case.
So is laparoscopic surgery using the da Vinci superior to traditional laparoscopic surgery? Preliminary research suggests it may be. But the question remains: is it worth the economic price we pay for the technology?
i Canadian Agency for Drugs and Technologies in Health. (September 28, 2010). Draft report - Robot-assisted surgery versus open surgery and laparoscopic surgery: Clinical and cost- effectiveness analyses. Accessed at http://www.cadth.ca/index.php/en/publication/2682
ii Ibid
iii Ibid
iv Vancouver Sun. (October 2, 2010). Meet Jack the surgical robot: He’s on the cutting edge of cancer treatment. Accessed at http://bit.ly/9f9gE0
v Ibid
vi “Watchful waiting” is a non-surgical intervention for prostate cancer. It involves a regular examination of the prostate and its PSA level. Immediate treatment (surgery or other) is only recommended if signs of cancer appear or change. Prostate cancer is not known to be an aggressive cancer. Some prostate cancers are very slow growing and can be present for years without affecting one’s health.
Thursday, March 10, 2011
Cancer Surgery and Robotics
Cancer is a disease that has plagued the human race for centuries. The world’s oldest documented case of cancer hails from ancient Egypt (1500 B.C.), while the first attempt to treat it surgically dates back to approximately 1600 B.C. Today’s surgical treatments have very little resemblance to the techniques used several centuries ago as our knowledge of the human body, of chronic disease and our technology are much more advanced.
One of the most amazing advancements is cancer surgery has come in the form of a robotic assisted surgery. Robotic assisted surgery was developed to overcome the limitations from minimally invasive surgery. Minimally invasive surgery, known as laparoscopic or keyhole surgery, is a modern surgical technique that is performed by making several small incisions (less than ½ inch) in the abdominal and pelvic regions. By inserting a small camera and tiny surgical instruments into these incisions, the surgeon performs the surgery while watching detailed images on a monitor . Laparoscopic surgery is an effective surgical technique and is mainly used for operations within the abdominal and pelvic regions as well as on the thoracic and chest cavities. This procedure is typically used to treat cancers of the abdominal and pelvic regions including prostate, colon, kidney and ovarian cancers as well as other cancers including throat and esophageal cancers.
Although traditional laparoscopic surgery is a very safe and successful surgical procedure, robotic assisted surgery was developed to improve this technique further. The most known robotic surgical system, and the only one available in Canada, is called the da Vinci Surgical system. The da Vinci Surgical system, owned and designed by Intuitive Surgical, consists of a surgeon’s console (remote control) and a patient side cart (the robot). The surgeon’s console consists of two hand controllers, two foot pedals, and a two-eye viewing screen. The side cart consists of 4 robotic arms, 3 for surgical tools, and 1 for a two lens endoscopic camera.
The surgical procedure using the da Vinci Surgical system is similar to a typical laparoscopic surgery except for one major difference. Unlike a typical laparoscopic surgery where the surgeon operates while standing over the patient, the da Vinci surgical system allows the surgeon to operate by controlling the robotic arms remotely from the console. While seated at the console, normally located in the same room as the patient, the surgeon uses the console’s controllers to manipulate the patients-side carts three or four robotic arms, while looking through the two-eye viewing screen.
The ergonomic design of the da Vinci allows the surgeon to perform the surgery in a much more comfortable manner compared to a typical laparoscopic surgery. The surgeon sits at the console and operates the robotic arms remotely, which come into contact with the patient, while directly viewing the procedure with his/her head rested on the two-eye viewing screen. Instead of standing over the patient using surgical tools while viewing the procedure on a monitor, the da Vinci’s design is seen to reduce fatigue and physical strain on the surgeon.
The design of the da Vinci also has a number of other advantages. This includes the jointed wrist design of the robotic arms, the da Vinci’s ability to translate, filter and scale the surgeon’s movements from the console, and the high definition stereoscopic image provided by the two-eye viewing screen and the two lens endoscopic camera. The jointed wrist design of the robotic arms provides increased dexterity not possible with the human hand. The da Vinci’s ability to filter and scale the surgeon’s hand movements from the controllers enhances the precision to perform complex, delicate procedures and allows the surgeon to operate in a much more graceful manner. The two-eye viewing screen and the two lens endoscopic camera provides the surgeon with a stereoscopic high definition view of the procedure and it provides a much better view of the surgery when compared to the image of the monitor used for a typical laparoscopic surgery.
Although these advantages come from the ergonomic design and the technology of the da Vinci surgical system, the question remains: do they translate into more successful and efficient cancer surgical procedures?
One of the most amazing advancements is cancer surgery has come in the form of a robotic assisted surgery. Robotic assisted surgery was developed to overcome the limitations from minimally invasive surgery. Minimally invasive surgery, known as laparoscopic or keyhole surgery, is a modern surgical technique that is performed by making several small incisions (less than ½ inch) in the abdominal and pelvic regions. By inserting a small camera and tiny surgical instruments into these incisions, the surgeon performs the surgery while watching detailed images on a monitor . Laparoscopic surgery is an effective surgical technique and is mainly used for operations within the abdominal and pelvic regions as well as on the thoracic and chest cavities. This procedure is typically used to treat cancers of the abdominal and pelvic regions including prostate, colon, kidney and ovarian cancers as well as other cancers including throat and esophageal cancers.
Although traditional laparoscopic surgery is a very safe and successful surgical procedure, robotic assisted surgery was developed to improve this technique further. The most known robotic surgical system, and the only one available in Canada, is called the da Vinci Surgical system. The da Vinci Surgical system, owned and designed by Intuitive Surgical, consists of a surgeon’s console (remote control) and a patient side cart (the robot). The surgeon’s console consists of two hand controllers, two foot pedals, and a two-eye viewing screen. The side cart consists of 4 robotic arms, 3 for surgical tools, and 1 for a two lens endoscopic camera.
The surgical procedure using the da Vinci Surgical system is similar to a typical laparoscopic surgery except for one major difference. Unlike a typical laparoscopic surgery where the surgeon operates while standing over the patient, the da Vinci surgical system allows the surgeon to operate by controlling the robotic arms remotely from the console. While seated at the console, normally located in the same room as the patient, the surgeon uses the console’s controllers to manipulate the patients-side carts three or four robotic arms, while looking through the two-eye viewing screen.
The ergonomic design of the da Vinci allows the surgeon to perform the surgery in a much more comfortable manner compared to a typical laparoscopic surgery. The surgeon sits at the console and operates the robotic arms remotely, which come into contact with the patient, while directly viewing the procedure with his/her head rested on the two-eye viewing screen. Instead of standing over the patient using surgical tools while viewing the procedure on a monitor, the da Vinci’s design is seen to reduce fatigue and physical strain on the surgeon.
The design of the da Vinci also has a number of other advantages. This includes the jointed wrist design of the robotic arms, the da Vinci’s ability to translate, filter and scale the surgeon’s movements from the console, and the high definition stereoscopic image provided by the two-eye viewing screen and the two lens endoscopic camera. The jointed wrist design of the robotic arms provides increased dexterity not possible with the human hand. The da Vinci’s ability to filter and scale the surgeon’s hand movements from the controllers enhances the precision to perform complex, delicate procedures and allows the surgeon to operate in a much more graceful manner. The two-eye viewing screen and the two lens endoscopic camera provides the surgeon with a stereoscopic high definition view of the procedure and it provides a much better view of the surgery when compared to the image of the monitor used for a typical laparoscopic surgery.
Although these advantages come from the ergonomic design and the technology of the da Vinci surgical system, the question remains: do they translate into more successful and efficient cancer surgical procedures?
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