Senhance: New robotic surgery to remove colon polyps

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Doctors at Advent Health in Orlando are using the newly Food and Drug Administration-approved Senhance system for minimally invasive abdominal surgery.

Unlike other robotic systems, Senhance provides real-time haptic feedback through a surgeon's fingertips.

Fifty-nine-year-old Deliz Flores was living in Puerto Rico two years ago when she started having sharp pain in her abdomen. But before she could see her doctor, Hurricane Maria struck.

"I couldn't keep the appointment," she said. "Everything was turned upside down."

Deliz relocated to Orlando with family, but in the months it took to resettle, her symptoms got much worse. Doctors found a colon polyp that needed to come out.

"I got scared, very scared," she said. "I said this is something I have to do right away."

Colorectal surgeon Dr. Teresa deBeche-Adams thought Deliz would be a good candidate for surgery with a new robotic system called the Senhance.

Tiny surgical tools are inserted through small holes in a patient's abdomen. Surgeons control the robot from a work station. Special glasses allow them to see inside the body in 3D.

But deBeche-Adams says the biggest difference is haptic feedback.

"It actually moves a little bit if we're putting too much tension on the tissues or pushing too hard," she said. "The robot actually tells us that's happening."

Surgeons were able to remove the polyp, which was cancerous.

"We did a perfect cancer operation for her," deBeche-Adams said. "All of the margins were negative. None of the lymph nodes had any spread to it. So, she's pretty much done."

"I'm 100 percent confident I made the right choice," Deliz said.

It's cutting-edge surgery, leading to a cure.

Because the surgery was minimally invasive, Deliz was out of the hospital three days after the cancer was removed. Normally, she would have required about a seven-day hospitalization.

DeBeche-Adams says in addition to cancer surgery, the Senhance can be used to treat conditions like diverticulitis and Crohn's disease.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: SENHANCE: NEW ROBOTIC SURGERY FOR COLON POLYPS
REPORT: MB #4562

BACKGROUND: Colon polyps are growths of tissue inside the large intestine, also called the colon. Some polyps are mushroom-shaped protrusions on the end of a stalk. Others appear as bumps that lie flat against the intestinal wall. Many times, people are not aware they have colon polyps because there are no symptoms. Larger growths can bleed, causing blood in the stool. Sometimes bleeding polyps can cause fatigue and other symptoms of anemia. On rare occasions, a large polyp can cause diarrhea or secretion of large amounts of potassium. This can cause marked fatigue and muscle weakness. If a polyp is not removed, it will continue to grow larger. It usually takes several years for a polyp to change to a cancer. However, some polyps have malignant cells even though they are small. About one-third of adenomatous polyps will progress to cancer in three to five years if undetected or ignored. (Source: https://www.health.harvard.edu/a_to_z/colon-polyps-a-to-z)

TREATMENT: Some early colon cancers (stage 0 and some early stage I tumors) and most polyps can be removed during a colonoscopy. This is a procedure that uses a long flexible tube with a small video camera on the end that's put into the person's rectum and threaded into the colon. For a polypectomy, the cancer is removed as part of the polyp, which is cut at its stalk (the part that looks like the stem of a mushroom). This is usually done by passing a wire loop through the colonoscope to cut the polyp off the wall of the colon with an electric current.

A local excision is a slightly more involved procedure. Tools are used through the colonoscope to remove small cancers on the inside lining of the colon along with a small amount of surrounding healthy tissue on the wall of colon. (Source: https://www.cancer.org/cancer/colon-rectal-cancer/treating/colon-surgery.html)

NEW TECHNOLOGY: The Senhance Surgical Robotic System received FDA clearance in October 2017, making it the first new market entrant to abdominal surgical robotics since 2000. For the first time in a robotic surgical platform, eye-tracking camera control enables surgeons to move the laparoscopic camera simply by moving their eyes. With haptic feedback, they can "feel" forces encountered by the robotic arms. Healthcare, like many industries, is experiencing a labor shortage as physicians retire or leave the profession. At the same time, the 65-and-older population, the primary users of surgical services, is expected to double by 2060, further straining the healthcare system. Surgical robots like the da Vinci and Senhance systems enable younger surgeons to perform at higher levels and help prolong the careers of our aging population of highly experienced surgeons. (Source: https://www.robotics.org/content-detail.cfm/Industrial-Robotics-Industry-Insights/Robots-and-AI-in-the-OR/content_id/7585)