Artistry of the da Vinci Xi: UMC one of few Nevada hospitals with breakthrough surgical technology

The da Vinci Xi has broader capabilities than prior generations of the da Vinci system, with the adaptability to be used across an array of procedures in urology, gynecology, thoracic, cardiac and general surgery.

Editor's note: This story was originally published in Health Care Quarterly, magazine about Southern Nevada's health care industry. Stories in Health Care Quarterly were submitted by doctors and their affiliates.

Building on its reputation of providing the highest level of care in Nevada, UMC now has one of the only surgical robotic systems of its kind in the state.

The da Vinci Xi has broader capabilities than prior generations of the da Vinci system, with the adaptability to be used across an array of procedures in urology, gynecology, thoracic, cardiac and general surgery.

Letticia Forde, a 23-year-old college graduate, was the first patient at UMC to undergo a procedure using this breakthrough technology. Throughout her college career, Forde suffered from ulcerative colitis – inflammation of the large intestine – which led to abdominal cramping and bloody persistent diarrhea, taking a destructive toll on her entire life.

“My first year of college in 2009 I had stomach pain. I would eat and not know what was going on. I thought I was eating the wrong kinds of food and then one day I had a bowel movement and there was blood in toilet. I was scared out of my mind,” said Forde.

She quickly made an appointment with her primary care physician who referred her to a GI specialist for a colonoscopy that showed ulcerative colitis.

Ulcerative colitis is ulcers in the lining of colon. At first, Forde’s physicians thought it could be controlled with medication, but by April 2014, the inflammation was worse and the side effects of the multiple medications, including severe bone density loss, were more than she wanted to handle. Her side was inflamed, she was gaining and losing weight, and worst of all she had to be in the bathroom 15-20 times a day. The disease was making it very difficult for Forde to get through college.

“It took over my life; it was very hard for me to go through school – I graduated but I wasn’t able to graduate with the grades I wanted and knew I could achieve. I missed a lot of class because my stomach would make loud noises and I would have to leave in the middle of a lecture for 15-20 minutes. It was very embarrassing,” she said.

Forde searched for a colorectal surgeon, finding Dr. Ovunc Bardakcioglu, chief of colon and rectal surgery of the University of Nevada School of Medicine and practicing at UMC. Bardakcioglu is fellowship-trained in colon and rectal surgery from Cedars Sinai Medical Center and the UCLA School of Medicine.

“When I met Forde I could tell she has been suffering for too long,” said Bardakcioglu.

“He told me my disease would only get worse and never better and that he had a cure for this,” said Forde.

The cure would be a three-step surgical process performed by Bardakcioglu controlling the hands of UMC’s brand-new surgical robot.

“The new robotics system at UMC is a perfect fit and it’s one of the only hospitals in the valley with the system,” said Bardakcioglu. “The advanced technology is superior to all others as it allowed me to work in the upper and lower part of the body at the same time. I was able to remove her entire colon using the robotics system.”

First, her entire colon was removed and she was given an ileostomy bag. Then, in three months her rectum will be removed and in the final step, Bardakcioglu will build her a new colon using her small bowel.

“This is one of the most technically difficult procedures as a colorectal surgeon. The beauty of the robotics system is the precision of the system. For rectal surgeries and a host of other procedures the system at UMC is superior — there is none better,” said Bardakcioglu.

During the surgery, Bardakcioglu controls the robot from a console, watching the process from a huge video screen. It’s the robot at the patient’s side following Bardakcioglu’s commands.

“The UMC robot has what’s called an ‘endo wrist,’ which makes its instruments very flexible. Conventional laparoscopy utilizes instruments similar to ‘chopsticks.’ On the UMC robot, I am able to control three arms with a switch on my foot that is assigned to the left or right hand rather than relying on my assistant’s hands and telling them what to do, I am able to do it myself. It cuts down on the communication and the need for an advanced skill set of another surgeon. Another big advantage is the 3-D camera, much like the difference between watching a movie from a VHS tape and watching it on a 3-D movie screen,” said Bardakcioglu.

Using UMC’s robotic technology, Forde doesn’t have an extraction site – she only has three incisions merely 8 millimeters wide. If Bardakcioglu would have done the procedure hand-assisted laparoscopically, her scars would have been 8-9 centimeters and using a traditional process, her entire abdomen would have been open. Thus, her in hospital recovery time was lessened to only 3-4 days, down from 10 days.

“I am already feeling so much better. I still have two more procedures to go and want them to go as smoothly as this one. I don’t even have any stitches, just a little bit of glue holding the tiny incisions together,” said Forde.

When she is fully recovered, Forde will have a completely rebuilt colon, with her energy level back and big plans to go to graduate school.

“Dr. Bardakcioglu is rewiring me with the use of UMC’s robot. That technology is pretty incredible!”

Business

Danita Cohen is the UMC executive director, strategic development and marketing.

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