Robot vs. Man: Who should perform complex surgeries?

Hudson Regional Hospital’s emergence as a ‘destination surgical center’ is the result of decisions and investments made shortly after new owners and leaders took the helm in early 2018. Shown, from left, are Mazor (spine surgery), Stryker Mako (orthopedic surgery), da Vinci Xi (general surgery, OBGYN, bariatric, & hernia surgeries), Excelsius GPS (spine surgery).

When the expertise of a skilled surgeon is combined with the capabilities of robotic technology, patients benefit in ways ranging from better outcomes and fewer complications to greatly reduced blood loss and shorter recovery time, according to Yitzhack Asulin, MD, FACS, FACOG.

Dr. Asulin speaks from experience. The gynecologic surgeon has performed more than 1,300 robotic-assisted procedures, placing him in the top 1% to 2% of surgeons in the United States in terms of procedural volume, and the American Association of Gynecologic Laparoscopists (AAGL) has honored him as a “Surgeon of Excellence” in robotic gynecologic surgery. He performs complex pelvic-reconstruction procedures on both local residents and people who travel from across the country and even overseas to have him perform their surgery at Hudson Regional Hospital in Secaucus.

Hudson Regional Hospital’s emergence as a “destination surgical center” is the result of decisions and investments made shortly after new owners and leaders took the helm in early 2018. “Our vision is to have Hudson Regional provide the best that a community hospital offers — in terms of high-quality, comprehensive, patient-centric care — while also emphasizing several areas of specialization, including advanced surgical services,” said Nizar Kifaieh, MD, MBA, CPE, FACEP, hospital President and CEO.

“In my opinion, we’ve reached the point where we really have to question whether it is appropriate to perform a traditional, open procedure if that procedure can be done in a robotically assisted fashion. The advantages to the patient in terms of reduced amount of bleeding and rate of infection, reduced post-operative pain, and faster recovery time are just so great, that I think this question needs to be asked — and answered in favor of robotic-assisted surgery.”

Yitzhack Asulin, MD, FACS, FACOG, director of Female Pelvic Reconstruction and Robotic Surgery, Hudson Regional Hospital

Hospital Chairman of the Board Yan Moshe, Dr. Kifaieh and other leaders pursued that vision by building a broad, deep roster of highly experienced surgeons in a range of specialties and by acquiring two state-of-the-art robotic surgical platforms. The first, the Mazor Robotics Surgical Guidance System, facilitates high-precision spinal and other orthopedic surgeries to treat conditions including disc herniation, degenerative disc disease and scoliosis. The second, the da Vinci XI robotic surgical system, is employed in minimally invasive procedures including hysterectomy, prostatectomy, hernia repair, bariatric surgery, and other abdominal and pelvic surgeries.

“The surgeries that we can perform with our robotic technology include some of the most common procedures in the United States. For example, each year, roughly 600,000 women have a hysterectomy. When I was doing my Ob/Gyn residency, women having a tradition hysterectomy with a large, open incision faced a long and painful recovery,” Dr. Asulin said. “Now, the techniques we can use with the da Vinci robotic surgical system require only a couple of tiny incisions – each just one-third of an inch long – and involve little to no blood loss, much faster recovery and significantly reduced post-operative pain. This last point is significant not only in terms of quality of life, but also because it allows us to keep patients comfortable with a much less-aggressive pain medication regimen, which is an important consideration.” Patients typically can go home the day of their surgery or the following day, the surgeon said.

Hudson Regional Hospital’s robotic surgery program started with a focus on two areas: gynecologic and pelvic-reconstruction procedures, and spinal and other orthopedic surgeries, Dr. Asulin said. From there, the hospital and its surgeons have been moving steadily to expand the role of robotic technology in urologic, bariatric and abdominal surgeries, he said, noting that eventually, Hudson Regional’s surgeons also will employ robotics for cardiothoracic surgeries.

“It is not uncommon today for a hospital to have a robotic surgery platform, and to employ it in one or two types of surgery, but few hospitals have made the commitment that Hudson Regional Hospital has to stay on the cutting edge of robotic-assisted surgery, and to make the benefits of this technology available to so many different patients undergoing so many different procedures,” Dr. Asulin said. As part of that commitment, he said, the hospital is completing the process to be designated a Center of Excellence by the AAGL, an independent organization dedicated to advancing the use of minimally invasive surgery in women’s health.

Dr. Kifaieh, the hospital’s CEO, said that Hudson Regional Hospital’s commitment to making the latest minimally invasive surgical techniques maximally available to area residents is reflected in the hospital’s in-network participation with numerous major health plans. “By developing our robotic surgery program, we are enabling area residents to receive outstanding surgical care without travelling into New York City. But in addition to sparing them the hassles of Manhattan traffic jams, we also want to help them avoid any hassles, detours and delays related to network status,” he said.

Meanwhile, the safety, effectiveness, and other benefits of robotic-assisted surgery have been so well-demonstrated that “in my opinion, we’ve reached the point where we really have to question whether it is appropriate to perform a traditional, open procedure if that procedure can be done in a robotically assisted fashion,” Dr. Asulin said. “The robotic platform provides the surgeon with an extraordinary degree of precision in dissecting out pathology and performing complex repairs, all the while sparing surrounding healthy tissue. Further, the advantages to the patient in terms of reduced amount of bleeding and rate of infection, reduced post-operative pain, and faster recovery time are just so great, that I think this question needs to be asked — and answered in favor of robotic-assisted surgery.”

Hudson Regional Hospital is located at 55 Meadowlands Parkway in Secaucus, and is easily accessible from routes 1, 3, 9 and 17, I-495; the New Jersey Turnpike; the Garden State Parkway; and the Lincoln Tunnel. To learn more about the hospital’s robotic-assisted surgery program and other services, visit hudsonregionalhospital.com.

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