‘Robotic surgery worked for me!’

An ordinary blood test turned out to be anything but routine for Brad Woodiwiss, a 53-year-old postal supervisor from Lone Tree, Iowa. His PSA count—a measure of  prostate specific antigen—suggested something was amiss. “I had gone to our local UI Health Care clinic for a check-up,” he says. “I hadn’t had any symptoms that I know of.”

Brad Woodiwiss of Lone Tree enjoys walking his dogs in his spare time.

A biopsy confirmed the presence of prostate cancer and led to an appointment with urologist Chad Tracy, MD, a member of the UI’s minimally invasive robotic surgery team. Tracy informed Brad that, unfortunately, he would need to have the prostate removed.

After quickly developing a trust in Tracy’s skills, Brad didn’t blink. “Dr. Tracy was experienced with robotic surgery, an important factor for anyone doing this type of work as far as I’m concerned. I felt confident he would do it right.” Furthermore,  Brad says he can’t imagine a better option for prostate removal than robotic surgery.

In his case, the procedure was complicated by the fact that he had undergone heart surgery two years earlier, and he was taking aspirin therapy. Patients undergoing surgery need to temporarily stop taking aspirin because of its blood-thinning properties. However, after working that complication out with his UI Heart and Vascular Center physician, Brad was given the green light for robot assisted surgery.

Afterwards, Brad walked out of the hospital—albeit gingerly— the next day. “They said I could spend another night if I wanted but I was ready, even if it wasn’t the most comfortable ride home. Things got better pretty much every week after that.” From a recovery standpoint, Brad feels lucky. He was back at work after six weeks.

Best of all, his PSA scores are “non-existent,” meaning the cancer is gone. “I’m really happy,” Brad says. “The outcome couldn’t have been better!”

Robot-assisted surgery on the rise

Robot-assisted surgery gives physicians greater range of motion and more precise control of instruments while offering patients potential advantages, including:

  • Faster recovery time
  • Shorter hospital stays
  • Less blood loss (fewer transfusions)
  • Less discomfort (fewer pain medications)
  • Lower cost

Since its introduction at University of Iowa Hospitals and Clinics in 2002, UI surgeons have performed over 1,300 procedures. The numbers continue to climb—more than 200 procedures in each of the past three years—as the technology becomes more popular with doctors and patients alike. In robotic surgery, a robot helps the surgeon do the job but the surgeon remains firmly in control. Using tiny incisions, the surgeon inserts a camera and surgical instruments into the patient’s body. The surgeon then uses a video console to view 3-D images of the patient’s insides while manipulating the surgical instruments with fingertip controls. This approach increases precision and allows movements that are impossible for the human wrist.

David Bender, MD, co-directs of the minimally invasive robotic surgery service at UI Hospitals and Clinics. The group includes surgeons from obstetrics and gynecology, urology, cardiothoracic surgery, and surgery, as well as surgeons with UI Children’s Hospital. The surgeons share two da Vinci robotic surgery systems. Bender describes robot-assisted surgery as minimally invasive (laparoscopic) surgery “enhanced.” In traditional laparoscopic surgery, surgical instruments are attached to the ends of long metal arms and placed inside the patient through small incisions. The surgeon then touches instruments directly to do the surgery. The robotic system enhances this minimally invasive approach. The doctor does not touch the surgical instruments directly but moves them by using a computer that translates his or her hand movements. This approach greatly increases precision and allows intricate movements that would otherwise be impossible.

“Robotic surgery has become the standard choice for certain surgeries such as removal of a cancerous prostate and surgeons continue to apply the system to a broader range of surgical situations,” Bender says. “We want to continue to incorporate this as a tool like any other in our operating rooms,” Bender added. Surgeons in-training are now learning this technique in addition to the more traditional approaches they currently must master. UI Hospitals and Clinics is unique in Iowa in that it is the only teaching hospital that offers residency and fellowship programs that teach robotic surgery. As part of this on-going commitment to fostering expertise in robotic surgery, the UI plans to establish a skills lab with a third robotic system dedicated to the training of surgical residents and fellows.