In the ever-evolving battle against cancer, the surgical robot is on the front lines. UC Irvine Healthcare last year established the Robotic Oncology Center, bringing together diverse medical specialties that use robotic surgery to pool expertise and promote advancements with the new technology.
"To our knowledge, there isn't another center in the country specific to robotic oncology," says urologic oncologist Dr. Thomas E. Ahlering, co-director of the Robotic Oncology Center and a nationally known expert in robotic prostatectomy. He has performed more than 1,000 robotic surgeries to treat prostate cancer and has pioneered advanced techniques to reduce postoperative urinary difficulties.
For surgeons, robotics can offer enhanced precision, dexterity, range of motion and imaging during operations. For patients, the technology can mean less injury to nearby healthy tissue, smaller scars, reduced pain, decreased need for medication, less likelihood of infection and faster recovery.
At UC Irvine Medical Center, robotic surgery is being used to treat prostate, thyroid, kidney, lung, ureteral, colorectal and gynecologic cancers. Soon to follow are robot-assisted surgeries for stomach, mouth, throat and larynx cancers at Orange County's only university hospital center.
Last July, Dr. Jason H. Kim, a UC Irvine specialist in treating head and neck cancer, became the first surgeon on the West Coast to perform robotic thyroidectomies, which remove the diseased gland without leaving a visible scar on the neck.
"We're excited to be able to offer this kind of surgery to the Orange County community," Kim says. "Traditional 'open' surgery to remove the thyroid gland requires a 3- to 5-inch incision across the front of the neck, and other minimally invasive surgical techniques can reduce the scar to about 1 inch. But with the robot, we avoid the neck incision altogether by making a small, easily hidden cut in the patient's armpit. That opening provides access for the robot's arms, which then are maneuvered by the surgeon to the thyroid."
The Robotic Oncology Center is part of UC Irvine's Chao Family Comprehensive Cancer Center, one of just 40 National Cancer Institute-designated comprehensive cancer centers in the United States and the only one in Orange County. In 2002, UC Irvine doctors were the first in Southern California to perform robotic prostate surgery, using the da Vinci system. The medical center now has three robots for surgeries and a fourth for training, making the Robotic Oncology Center one of the busiest robotic training facilities for surgeons on the West Coast.
Use of the da Vinci technology is expanding under Dr. Robert E. Bristow, UC Irvine's director of gynecologic oncology, who gained extensive experience with robotics at Johns Hopkins University. Bristow performs various procedures, including robot-assisted radical hysterectomy and total laparoscopic hysterectomies; UC Irvine Medical Center is one of the few in Southern California to offer these minimally invasive operations. He also uses the robot to treat cervical, endometrial and ovarian cancers.
"Traditionally, endometrial cancer is managed with a full laparotomy - a 12- to 18-inch incision in the abdomen, resulting in a three-day hospital stay and a six-week recovery," says Bristow. "The robot enables us to do the same operation using four or five tiny incisions and with better-wristed instrumentation and three-dimensional visualization. We can work around corners and underneath things, which we couldn't do previously."
As a result, blood loss is minimized, procedures are safer, hospital stays are shorter and recovery time is dramatically faster, enabling patients to return to full activity and work more quickly.
"This center is vitally important to our community," Ahlering says. "Typically, cancer involves radical procedures. The Robotic Oncology Center emphasizes minimally invasive approaches that achieve equal or better medical outcomes." UC Irvine has developed a technique that uses hypothermia, or cool temperatures, during robot-assisted prostatectomy to improve post-surgical continence and potency. UC Irvine urologists are enrolling patients in a clinical trial, currently under way.
"The Robotic Oncology Center is a prime example of how an academic medical center can pool the talents of its world-renowned surgeons to provide the highest quality of robot-assisted cancer care to Orange County and beyond," says Dr. Ralph V. Clayman, dean of UC Irvine's School of Medicine and an internationally recognized authority in minimally invasive renal surgery.
"Our new center, which focuses on the specific application of robotic technology to cancer surgery, enables us to continually advance this exciting technology and create university-led innovations, much to the betterment of every patient who seeks our care."
"To have this in our own backyard," says urologist Dr. Michael K. Louie, co-director of the Robotic Oncology Center, "is a wonderful gift to the Orange County community."
UC Irvine's Robotic Oncology Center offers minimally invasive treatment for cancer and other diseases. READ FULL STORY »
Dr. Robert Bristow followed his dad into medicine, becoming an expert in gynecologic cancer. READ FULL STORY »
A minimally invasive hysterectomy cured Jean Teetor's severe pain and helped her return to work quickly. READ FULL STORY »