More machine now than man: Robotic surgery at AdventHealth Palm Coast

Instruments with great dexterity mimic surgeons' hands at workstation monitor in operating room.

By Brian McMillan
| 12:30 p.m. March 7, 2020

The da Vinci Xi is an upgrade over the Si in that it allows for multiple locations to be worked at once. Photos by Paola Ohlson

Dr. Farhaad Golkar and his patient, Thomas Ledwith. Photo by Brian McMillan

Robotic surgery gives a surgeon the same dexterity as he has in his own hands, all controlled through a workstation monitor in the operating room.

Palm Coast Observer
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When Thomas Ledwith was told he needed to have surgery to repair a hernia, the surgeon asked him if it would be OK to use a relatively new device: the da Vinci Xi. It’s the latest in robotic surgery, the surgeon said.

Three types of surgery

Open

Golkar said there are three types of surgery. The first is what most think of: when the surgeon cuts open the patient and works on the body with his hands.

Laparoscopic

The second is laparoscopic surgery, which is when the surgeon makes a small incision in the body and then uses cameras and computer technology to manipulate long instruments to work inside the body. Golkar compared the instruments to chopsticks. It’s less invasive than open surgery but has limited mobility, and it’s physically demanding on the surgeon, who might be standing over the body for hours.

Robotic

The third type of surgery is robotic, which is similar to laparoscopic, but with some key improvements. First, rather than chopstick-like instruments that can pinch but that’s about it, the robotic instruments in the body have the same mobility as a human hand. As the surgeon moves his or her hand in a workstation with a monitor, the instrument mimics the same movement in the patient's body.

That allows the surgeon to suture shut a hernia, which is essentially a hole that shouldn’t be there, enabling the body to heal more quickly and more completely. In laparoscopic surgery, there isn’t enough dexterity to tie a suture, so surgeons use instruments similar to a staple gun to fire plastic harpoon-line staples to keep the mesh in place long enough for the body to become integrated with the mesh and prevent future hernias.

Ledwith, a 71-year-old Flagler Beach resident, agreed.

“If it’s easier for the surgeon, then it’s easier for the patient,” he reasoned.

After the surgery in February, he returned to AdventHealth Palm Coast on March 5 and got a thumbs up from the surgeon, Dr. Farhaad Golkar, who spent time with the Palm Coast Observer to explain how the technology works.

Essentially, he said, robotic surgery is like seeing in 3D, compared with laparoscopic surgery, which is like seeing in 2D.

"The surgeon is completely in control of the operation," Golkar said. "It's not like some artificial intelligence is doing it. The robot doesn’t make a single movement that the surgeon doesn’t also make. It mimics it."

Da Vinci Xi

AdventHealth Palm Coast has had robotic surgery for years, but it only recently acquired the latest model, the da Vinci Xi. It’s an upgrade over the Si model, allowing the surgeon to work through four different incision ports at once. That means colon cancer, for example, can be addressed robotically, rather than through open surgery.

The future

As the technology continues to improve, Golkar sees more and more benefits to robotic surgery.

“I think all surgeries will eventually be done like this,” he said, “even the ones that we do open now. … There’s less pain, faster recovery.”

Lung surgery is already being done robotically, he said, and heart surgery could happen in the future, if it’s not already being tried.

author

Brian McMillan

Brian McMillan and his wife, Hailey, bought the Observer in 2023. Before taking on his role as publisher, Brian was the editor from 2010 to 2022, winning numerous awards for his column writing, photography and journalism, from the Florida Press Association.