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Dr. Michael Lasser, Medical Director, Robotic Surgery Program

JFK Dr. Lasser

Robotic Surgery with Dr. Michael Lasser

Q. What exactly is robotic surgery?
A. That is a question I am asked a lot, and I’ve found it helpful to begin by explaining what robotic surgery is not. Specifically, robotic surgery is not a process in which a surgeon relinquishes control of an operation or any aspect of patient care to technology. This is not the surgical equivalent of a flight crew putting an airplane on auto-pilot. In fact, it is quite the opposite.

Robotic surgery actually enhances surgeons’ ability to visualize the anatomy, control the movement of very delicate instruments, and perform with great precision procedures often beyond the capability of other minimally invasive modalities. The practical benefits to the patient are considerable, and in some cases involve preserving or reconstructing a damaged organ that otherwise would not function properly, and that perhaps would have to be removed.

Q. How does robotic surgery provide you with this enhanced ability?
With the surgeon seated at a console featuring several highly responsive controls, a robotic-assisted surgical system translates his or her hand movements into smaller, more-precise movements of tiny instruments inside the patient’s body.

At JFK Medical Center, we employ the da Vinci Xi® Surgical System, the latest and most-sophisticated robotic surgery system available today, and one found at relatively few hospitals. The da Vinci Xi is the fourth generation of the da Vinci Surgical System, which was first approved by the FDA in 2000.

The da Vinci Xi System’s immersive 3D-HD vision system provides a three-dimensional view of the patient’s organs, blood vessels, and other vital structures, compared with the 2-D view available with laparoscopy, another minimally invasive technology. Further, while laparoscopy generally provides 3-fold magnification of the surgical field, our da Vinci system provides 10-fold magnification.

I particularly value the da Vinci Xi® Surgical System’s “Endowrist” feature. This technology provides a surgeon with the same range of motion in maneuvering his or her wrist that he or she would have in a traditional procedure. This is incredibly helpful with stitching and delicate reconstructive work.

Q. Beyond the example you’ve already cited, how do these enhanced capabilities translate into benefits to the patient?
A. They can mean less risk of complications and less blood loss during surgery and, postoperatively, less time in the hospital, less need for narcotic pain medication, , and less recovery time compared with traditional surgery. The increased precision offered by robotic-assisted surgery also means we can perform complex procedures on patients who might not otherwise have been candidates for those operations.

Q. What sort of procedures are performed with the assistance of robotic technologies?
A. The da Vinci Surgical System, developed by Intuitive Surgical, initially was used primarily in urologic procedures, and today well over 90% of prostate cancer surgeries are done robotically. In my own practice, I employ the da Vinci Surgical System for procedures including radical prostatectomy, partial nephrectomy, reconstructive procedures, and surgeries to correct congenital kidney problems.

In the 16 years since its approval by the FDA, however, its use has steadily expanded into other areas. At JFK Medical Center, we are using the system in colorectal and urological surgeries, and will be employing it in general surgery and, eventually, gynecologic procedures, as well.

This increased use of the da Vinci Xi Surgical System is part of a larger commitment the medical center has made to offering patients a wide array of sophisticated operative technologies, and is accompanied by an expansion of our roster of surgeons in various specialties who have been trained in robotic procedures.

Q. What else should patients know about robotic surgery?
A. That it is a means to an end, not an end in itself. The end we’re focused on is providing outstanding patient care and achieving the best outcomes possible. You won’t find anyone more enthusiastic about robotic surgery than I am, but I don’t hesitate to select another operative approach when it is better suited to a given patient’s individual needs. I mention this because occasionally a patient will be a little disappointed when we explain that traditional surgery, laparoscopy, or non-surgical management is preferable for him or her due to specific considerations, such as anatomical factors. Again, our concern is the patient, and we formulate treatment plans, select procedures, and employ technologies based on what’s best for him or her.

Dr. Lasser earned his medical degree from Rutgers – Robert Wood Johnson Medical School and completed his urology residency at The Warren Alpert Medical School of Brown University, where he was selected to serve as Urology Chief Resident. He then completed a Society of Robotic Surgery Certified Fellowship at Albert Einstein College of Medicine/Montefiore Medical Center in New York City.