Robot provides Stanford Health Care – ValleyCare patient with shorter, less invasive surgery

Stanford Health Care – ValleyCare physician performs surgery on a cancer patient with the help of a da Vinci robotic system. The technology eases patients’ recovery and offers surgeons a clear view of the procedure.

Isabel Lazo controls an arm of the da Vinci robotic system at Stanford Health Care – ValleyCare. The new system enables surgeons to perform procedures more efficiently, leading to a shorter recovery time for patients.
Courtesy of Stanford Health Care

Pam had no obvious signs of cancer — no bleeding or other symptoms. When abdominal pain sent her to the emergency department, an ultrasound showed a thickening of the uterine wall. Her nurse practitioner at Stanford Health Care – Emeryville referred her to a Stanford Medicine gynecologist, who made an unexpected diagnosis: endometrial cancer, or cancer of the uterine lining.

“The most amazing thing is that they found this, which was a miracle, because I didn’t really have any symptoms,” said Pam, a freelance writer in her 60s who didn’t want her last name used.

Three weeks later, Pam was in an operating room at Stanford Health Care – ValleyCare in Pleasanton, where surgeons used advanced robotic technology to remove her uterus, ovaries and fallopian tubes. She was among the hospital’s first patients to benefit from the latest generation of the da Vinci robotic system, which enables surgeons to perform complex procedures through tiny incisions.

The technology minimizes pain and bleeding, enables patients to leave the hospital sooner, and speeds their recovery. For Pam, the state-of-the-art system had another advantage: Surgeons used its capability to detect and remove potentially cancerous lymph nodes.

“It makes us more efficient and decreases the operating time, which is always safer for the patient,” said Isabel Lazo, MD, a clinical assistant professor of gynecologic oncology and Pam’s surgeon. “Enhanced technology — the way the instruments move and allow us to visualize things on a screen — facilitate surgery, making it safer.”

Isabel Lazo

Stanford Health Care – ValleyCare recently acquired the system through a $2 million grant from the ValleyCare Charitable Foundation, now under Stanford’s Medical Center Development Office. With the latest technology, the hospital is expanding its robot-assisted surgical options to include procedures for the chest, heart, lungs and parts of the abdomen, as well as for gynecologic and colorectal procedures, said Valerie Sugiyama, MD, a clinical assistant professor of gynecologic oncology.

How it works

Surgeons operate the system while sitting at a console that controls a robotic arm. The surgeon uses the arm to make a small incision to insert delicate instruments, including a video camera that offers a three-dimensional, magnified view of the surgical site in real time.

Watching a console screen that displays that view, the surgeon then manipulates a scalpel, scissors, graspers and other tools. A second surgeon remains at the patient’s bedside.

Lazo said the device gives her a clear and direct view of the surgical site where she’s working. “There is depth to the image you are looking at,” she said.

Because small incisions are made, patients have less pain and bleeding than they would after conventional surgery. The new device is also easier to set up and requires fewer steps to place the patient in the ideal position, thus reducing the time the patient spends in the operating room, Lazo said.

In cancer patients, clinicians using the system can quickly find the lymph nodes to which the cancer, if it has spread, is likely to be found. During surgery, they inject fluorescent dye into the site, lighting up nearby lymph nodes. In Pam’s case, some lymph nodes that were removed for analysis were determined to be noncancerous.

Pam, who spent a night in the hospital, said she was feeling “pretty good” by the third day and now feels like she is making “an incredibly fast recovery.”

“I’m grateful I had fantastic nurses. They were truly amazing. I probably got the greatest surgical care, though I wasn’t conscious during the process. I would say all great things about ValleyCare. I was favorably impressed,” she said.

“We are pleased to be able to offer this technology to our community and look forward to bringing the East Bay the latest minimally invasive surgical options,” said Rick Shumway, president and CEO of Stanford Health Care – ValleyCare.

“Through the support of the ValleyCare Charitable Foundation, we were able to make this significant investment to enhance the care we provide to our community and benefits our patients with a faster recovery, less pain and an earlier return to their daily activities.”



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