Doctors map the future of medicine at new center
By Idan Ivri
Sept. 21, 2002 9:00 p.m.
Robotic surgery has stepped out of science fiction and into
reality.
On Aug. 30, UCLA announced the opening of the Center for
Advanced Surgical and Interventional Technology.
CASIT will feature new surgical tools, simulators to train
doctors, offices for corporate partners in medical technology and a
control center that will receive and broadcast messages around the
world.
The center will primarily function as a hub for
technology-related medical science at UCLA.
The center comes at a critical time, as new medical technologies
are coming into practice and demanding more knowledge from
physicians than ever before, according to Dr. Peter Schulam,
associate professor of urology and co-director of the center.
“We realize that surgical training as we have been doing
it is not adequate for new technologies,” he said.
“(The center) fills the void that is coming to bear because
of these new tools.”
To narrow this gap, the center will act as a liaison between the
university and the world of medical engineering.
Running the center will be a joint effort involving UCLA doctors
from the departments of surgery, radiology, neurosurgery, urology,
and medical engineering, along with support from several private
corporations.
Schulam believes CASIT’s strength is in its adaptability
to new developments in technology.
One of the most promising aspects of CASIT today is the ZEUS
Robotic Surgical System, a remote controlled medical robot. ZEUS
can be operated by a doctor in the next room or as far away as
another continent, as its cameras allow a full range of vision to
the surgeon in control.
To perform the surgery, ZEUS has three robotic arms which
replicate the intricate hand movements of the surgeon.
ZEUS’s biggest advantage over traditional surgery is in
“˜minimally invasive’ techniques.
Traditionally, surgeons cut large incisions on a patient during
major surgery to allow them to see and operate. ZEUS, on the other
hand, only requires tiny holes on the patient for its thin robotic
arms. Some of the arms are outfitted with cameras, some with
surgical tools.
Dr. Joseph Hines, assistant professor of surgery and director of
the UCLA Heartburn Treatment Center, used CASIT’s ZEUS
Robotic Surgical System in August to operate on patient David
Ritchie, a 52-year-old school bus driver who suffered from severe
acid reflux disease.
Acid reflux is a severe form of heartburn in which acidic food
and fluid rises from the stomach into the esophagus, causing great
pain. Most cases of acid reflux disease, which afflicts about 40
million Americans, can be treated by medication.
Ritchie’s case, however, was even more extreme.
Before the surgery, Ritchie couldn’t sleep or eat
comfortably. “Medicine lowers the amount of acid in the
stomach, but the food can continue to reflux,” Hines
explained.
The surgical procedure to treat acid reflux is called Nissen
fundoplication. The procedure tightens the passageway from the
stomach to the esophagus, keeping food from rising, or refluxing,
once it has been ingested.
CASIT is participating in a study that will involve the
performance of 10 robotic Nissen surgeries, of which
Ritchie’s was the first.
“There is a fair amount of sewing that the robot helps us
with because it articulates all degrees of freedom; it makes
suturing and tying the knots easier,” Hines said.
After the surgery, Ritchie only had a few small incisions on his
body instead of a long cut with many stitches, the traditional sign
of a non-robotic Nissen procedure.
Agreeing with Schulam, Hines said that the ZEUS system can
function as a teaching tool for doctors, much like a
flight-simulator trains airline pilots before they fly for
real.
With ZEUS, the student and teacher surgeons don’t even
have to be located in the same country.
Among doctors in various other fields of medicine, heart
surgeons are interested in ZEUS as a way to avoid opening the
entire chest during heart surgery.
Since the robotic arms can twist like a human wrist, there may
be dozens more types of surgery that can be similarly transformed
into less invasive alternatives.
Each ZEUS system is priced at about $1 million, making it an
expensive investment. The initial seed money for CASIT was secured
largely due to the efforts of Dr. Gerald S. Levey, provost of
medical sciences and dean of the UCLA School of Medicine.
