The Logical Next Step in Colorectal Surgery

By: Jerald Wishner, M.D., FACS, FASCRS
Thursday, January 3, 2013

Northern Westchester Hospital expands its Robotics Institute with the addition of the newly introduced da Vinci Si Surgical system Robot. The advanced 3-D, HD visualization and innovative instrumentation open a world of possibilities for patients needing colorectal surgery.

Used to surgically treat conditions such as diverticulitis, colon polyps or tumors, and rectal prolapse, the da Vinci Si Surgical System robot provides surgeons at Northern Westchester Hospital state-of-the-art instrumentation and visualization to minimally invasively operate deep within the small confines of the pelvis — areas previously accessed only by open surgical techniques.

Jerald Wishner, M.D., FACS, FASCRS, Co-Director of the Institute for Robotic and Minimally Invasive Surgery at Northern Westchester Hospital, controls the robotic instrumentation from a console a few feet from the operating table. The platform’s EndoWrist instruments afford him 336˚ of articulation and eliminate natural tremor. Access afforded by the platform’s range of motion provides patients with pelvic tumors or rectal cancers more options. Robot-assisted, minimally invasive surgery enables smaller incisions that result in less pain and shorter hospital stays.

The ingenuity of the da Vinci instrumentation design is complemented by innovative visualization technology, which significantly enhances operational benefits. In an anatomic location where the margin of error for successful tumor resection may be millimeters, the da Vinci’s camera provides the surgeon high-resolution, 3-D visualization of the targeted area.

“I’ve been performing surgery for 20 years, and the visualization with the da Vinci is better than anything I’ve ever seen, either in open surgery using big incisions or laparoscopic procedures before we had the robot,” Dr. Wishner says. “Millimeters make a difference. We want to get the tumor, but we don’t want to injure nearby nerves that may affect the patient’s sexual function or continence.”

Training to Make a Difference

Unlike the advent of laparoscopic technology — for which multiple companies conducted multiple training facilities — Intuitive Surgical is the only company producing the da Vinci robot, Dr. Wishner notes. As a result, the training structure provides clearer guidance to equip surgeons for the various situations they may encounter in the operating room.
In preparation for performing robot-assisted surgery, Dr. Wishner completed a comprehensive training program that provided exhaustive background on the technology and equipment, many hours observing certified surgeons operating with the robot, as well as opportunities to perform procedures on an advanced surgical simulator to further hone his skills. The final aspect of training included proctoring by a trained surgeon for a minimum of five procedures.

NWH Continues Investing in Technologically Advanced Care

Dr. Wishner recalls the surgeons who observed his training marveling at the technology available at Northern Westchester Hospital. In fact, it was the facility’s commitment to providing surgeons with the most advanced technology that drew him there in 2006 and perpetuates the drive to deliver the best care to as many patients 
as possible.

“I think I owe it to patients, when they come to see me in the office, to offer them all possible options,” says Dr. Wishner. “I sit down with the patient, and together we figure out which option makes the most sense. I would be doing the patient a disservice by not offering the most state-of-the-art opportunities for minimally invasive procedures.”

For more information about the Institute for Robotic and Minimally Invasive Surgery at Northern Westchester Hospital, please visit