SARASOTA -- Conventional surgery for esophageal cancer requires a scalpel cut of roughly 2 feet long, from the top of the breastbone down below the stomach.
"The surgeon has to go between the lungs and under the heart," said Karim Ghazli, a surgical team member at Sarasota Memorial Hospital. The surgery usually requires weeks of recovery along with the long scars.
But a new system unveiled by Sarasota Memorial Hospital on Monday will make it possible to do the surgery, including removing cancer-devastated portions of the throat and grafting new flesh from the stomach or colon, all using a human-guided robot. The $1.5 million robot is called da Vinci Xi.
Sarasota Memorial Hospital also recruited Dr. Kenneth Meredith, the doctor regarded as one of the world's most experienced robotic surgeons.
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The surgeon and robot will make several inch-long incisions around the waistline and enter the body with its long thin arms. Patients will be on the way to recovery a lot sooner with the less invasive nature of the surgery.
"It's exciting that Ken is joining us," James Fiorica, chief of staff at Sarasota Memorial, said at a news conference Monday announcing the new robot and doctor.
Meredith comes to Sarasota by way of Madison, Wis., where he was director of robotic surgery at the University of Wisconsin Hospital and Clinics. He has done more than 200 esophagus cancer surgeries with the robot, more than anyone in the world, Fiorica said.
He's so proficient that Intuitive Surgical, which makes the robot, incorporated his suggestions in its latest iteration of the robot.
"Dr. Meredith is also ranked No. 3 in the world in pancreatic robotic surgeries," said Fiorica.
The surgeon still does all the snipping, pulling and sewing, but the robot's pinchers don't tremble even a tiny bit, something all humans do to some degree.
The robot has four arms. It can insert a 3D camera into the patient, it can cauterize, and can cut and sew. The surgeon guides the arms with his thumb and forefinger, sort of like little joysticks. The surgeon sits on a chair near the arms and puts his head into an eye piece. The view inside the eye-piece is like a 3D movie, bringing to mind the 1966 film, "Fantastic Voyage," where a surgical team is put in a submarine and shrunken to microscopic size to enter the bloodstream of a dying man.
"The image is magnified 15 times," Fiorica said. The heightened visual allows the surgeon to really see depth, including features on arteries and tumors that wouldn't normally be seen.
The surgeon uses foot pedals to further guide the robot. Meredith shed his shoes to demonstrate it on Monday.
The video game feel of the whole thing is not lost on the doctors, who say the next generation of doctors who grew up with video games on phones, tablets and TVs may have an easier learning curve than present-day surgeons.
"With the Xi, we can now operate on those hard-to-reach areas," Meredith said.
Meredith, trained in surgical oncology at the Moffitt Cancer Center, will start next week. His expertise is using the robot to remove malignancies of the pancreas, liver, biliary tract and esophagus.
Sarasota Memorial now has four da Vinci robots and more than 24 experienced robotic surgeons who, together, have performed more than 3,750 procedures since the hospital got its first surgical robot in 2006, Fiorica said.
"We have the largest and most experienced robotic program on the west coast of Florida," said hospital spokeswoman Kim Savage.
Sarasota Memorial has used the robot for procedures in cardiovascular, thoracic, urology, gynecology, oncology and general surgery.
Richard Dymond, Herald health reporter, can be reached at 941-745-7072.