Webster’s defines the word dexterous as “Skillful and competent with the hands.” So, it would be fair to say that Kettering Medical Center’s new robotic surgery system, “Dexter”, is aptly named.

With a skilled surgeon at the controls, Dexter is an extension of the doctor’s hands and provides unprecedented control, vision and access. Patients enjoy the benefits of reduced recovery time, less pain and better outcomes, which all make Dexter well worth the $1.5 million investment it took to bring him to KMC.

The “Da Vinci S,” which Kettering placed in service this May, is the latest in robotic surgery systems, equipped with three surgical arms and the ability to reposition itself on command. It is only one of three such systems in the state of Ohio, and it is the first in the Dayton area.

Da Vinci S, brought onto the market in January, features one more surgical arm than the previous generation of robotic surgery systems. With rapid instrument exchange and multi-image display capability, it is one loaded machine with great appeal for surgeons.

But for Safwat Zaki, MD, a urological surgeon at KMC, the real appeal is for his patients. “The main advantage is instead of having the big 6-8 inch incision with traditional prostate resection you have small surgery, incisions you can usually close with surgical tape,” Dr. Zaki said. “Pain is less and hospital stay is much quicker. . . about two days or less on average. The catheter stays in much less time – about a week vs. at least two weeks with traditional surgery. There is a lower chance of incontinence and less chance of impotence – the two big complications you see from prostatectomy. There is also a better chance of total removal of the cancer with less chance of it coming back.”

Dr. Zaki was glad to finally meet Dexter, as several of his patients requested robotic surgery after hearing about it through the media. He was the tri-state area’s first surgeon to perform a prostatectomy with the use of laproscope four years ago, and the doctor is thrilled to now have the added benefit of the “Da Vinci S” for the good of his patients. Dr. Zaki added that all potential patients should welcome the use of the new robotic system. Before joining the KMC staff, Dr. Zaki had two years experience with the first generation of robotic surgery systems while at the University of Cincinnati Medical Center.

“It’s a misconception that a robot will do the surgery. It allows the surgeon to perform a more delicate, accurate procedure using the benefit of technology,” Dr. Zaki said. “The robot has 15 times magnification over the human eye and is much more delicate than the human hand, and it can reach areas where the human hand can’t reach. The hand of the robot can also do things the human wrists cannot do.”

With Sharat Kalvakota, MD, assisting, Dr. Zaki performed the first two robotic procedures at KMC on May 2 and 3. Dr. Zaki was seated at the control console, operating the robotic arms from several yards away. Dr. Kalvakota scrubbed in and used laproscopic instruments to help change the instrument heads on the arms while they were still inside the patients.

There is a lot of communication between the team and the doctor at the monitor,” said Lauren Hatton, RN, Coordinator of Robotic Surgery for KMC. “The scrub tech, the first assist nurse, the circulating nurse and the assisting doctor – all of us worked as a team and made it successful. It was such a trill to see it in action for the first time.”

Prostate removal is the first application for Dexter, but Rick Mace, Vice President for Clinical Services at KMC, assures that it won’t be the last.

"Kettering Medical Center has been on the leading edge of technology from the very beginning. . . from PET scan, to bloodless brain surgery with Gamma Knife, to tools that allow a surgeon to view data in his field of vision the way a fighter pilot does,” Mace said. “Dexter is an extension of that, and we have only begun to scratch the surface of applications for robotic surgery. Soon surgeons at KMC will be using this device to assist in kidney, bladder and cardiac surgeries. It will have a dramatic impact on our patients, decreasing their pain, recovery time and potential complications."

“The future is good for robotic surgery,” Dr. Kalvakota said. “We can evaluate the anastomosis with this system to make sure it is water tight, where with traditional surgery we had to rely on balloon traction. There is also much less use of narcotics in recovery. It may not be as cost-effective right now for prostate removal, but there are just so many applications for this and benefits to patients . . . we can’t afford not to go down this road.”