A decade ago the idea that robots could perform a variety of difficult surgeries seemed far-fetched and more like a scene from a science-fiction film.
But the prevalence of robots in medicine is rapidly increasing in the islands.
Hawaii Pacific Health spent $4.5 million this month on surgical robots, one for its Kapiolani Medical Center for Women & Children and one for Pali Momi Medical Center. Kapiolani will be the first isle hospital to use the robot in pediatric surgeries, and Pali Momi will offer the first machine for the civilian population in West Oahu.
"This didn’t exist 10 years ago," said Dr. Michael Carney, a Kapiolani gynecologic oncologist and associate professor at the University of Hawaii John A. Burns School of Medicine. "It was somebody’s dream long ago, but it’s hard to believe it’s in reality now."
The Queen’s Medical Center and Tripler Army Medical Center, which is primarily for military patients, have used the machines in recent years for everything from head and neck surgeries to prostate and urological procedures, lung and gastrointestinal operations, heart valve repairs and weight-loss surgery.
The machines, which can help to remove uterine cancers or lymph nodes without a large incision, can carry tiny instruments including scissors, clippers and a camera into the body through 8- to 12-millimeter holes. The 3-D high-definition camera and tools are maneuvered through the body by a physician looking through a console.
"The machine will improve the quality by providing better dexterity, visualization, precision and control when using the robotic surgical system," Hawaii Pacific Health said. "The addition of the surgical robot will provide greater access to higher quality specialized surgical services to all pediatric and obstetric patients through greater access."
The Kapiolani robot will be used for pediatric and obstetric and gynecologic surgeries and in training medical residents from the John A. Burns School of Medicine. The robot will be used for general, urologic and thoracic procedures as well.
This type of minimally invasive surgery provides faster recovery times — same-day checkouts compared with as long as five days in the hospital — lowers blood loss, decreases the possibility of surgical infections and has resulted in greater patient satisfaction and outcomes compared with traditional open procedures, according to a certificate of need document Hawaii Pacific Health filed with the State Health Planning and Development Agency. Costs also are reduced because of the shorter patient surgical recovery time and length of stay in the hospital.
"The arms of robots are basically an extension of your arms with these little tiny instruments," Carney said. "We control every movement, every action of the robot. It’s just a tool for us to get the job done."