could not have scripted it any better. Within three hours after
David Bonner, Ph.D., underwent a bilateral hernia operation under
general anesthesia, he strolled into the grand opening of the
Medical Center's new minimally invasive surgery training center.
Dressed in sweats and sneakers, he looked liked he had just left a
basketball game, not a hospital bed. But there he was, a walking,
smiling, healthy advertisement for minimally invasive surgery the
brand of surgery that was chiefly responsible for his mobility so
soon after the procedure. And there was no script.
feel great," said Dr. Bonner, making his way through a crowd of
supporters and media members.
The purpose of the event on
J-4 on Jan. 28 was to cut the ribbon on the new center - formally
called the Minimally Invasive Surgery Center for Training and
Education (MTSCTE). The center is set up so residents, surgeons and
students can practice the techniques of minimally invasive surgery.
It is funded in part by a five-year, $1 million grant from the
United States Surgical Corp. of Norwalk, Conn., whose
representatives participated in the ribbon cutting.
minimally invasive surgery, physicians perform surgery with special
instruments through small, half-inch openings in a patient's body
rather than through large incisions that take longer to heal and
leave significant scars. Tiny high-resolution cameras permit
surgeons to see inside the body in ways far superior than with the
"Surgery will dramatically change in the
21st century," said Barton L. Sachs, M.D., M.B.A., associate
professor of surgery and MISCTE director. "We are committed to
be at the forefront of this devel- oping technology so that we can
offer the very best surgical care to our patients."
part of the day-long symposium and grand opening, which included
brief informational speeches by many Medical Center physicians who
use these surgery techniques, Dr. Bonner's surgery was broadcast
live to seven other institutions over the Adirondack Area Network.
Coincidentally, Dr. Bonner, The Sage College's director of
technology initiatives, provided the technical expertise in
establishing the network, which includes Albany Med's telemedicine
network. Albany Med physicians and invited guests viewed his surgery
live from Huyck Auditorium.
|David Bonner, Ph.D., center, is proof of
the benefits of minimally invasive surgery. Less than four hours
qfter a bilateral hernia operation, he visited his surgeon, T.
Paul Singh, M.D., right, at the MISCTE grand opening.
||The training center houses a
videoconference suite in which surgeons and students can watch
procedures as they happen in the Medical Center's operating rooms on
the other side of campus. At the center, surgeons, residents, other
members of the operating room team and even medical students work
with laparoscopic instruments and equipment, practicing new surgical
techniques on a series of progressively difficult nonclinical
In addition to providing a training site for
surgeons to learn these new techniques, MISCTE provides physicians
and scientists from the Medical Center with a state-of-the-art
facility in which to conduct joint research with U.S. Surgical. Such
joint efforts are expected to result in new instruments and
techniques that will provide patients with a broader range of these
less invasive procedures.
It is estimated that 30 percent
of the more than 27,000 surgical procedures performed at the Albany
Medical Center are minimally invasive. Dr. Sachs, who often refers
to minimally invasive techniques as 'Nintendo Surgery,"
estimates that up to 75 percent of all procedures eventually will be
done through small openings in the body. Statistics show a steady
yearly increase in all forms of minimally invasive surgery performed
from 1995 through 1998. During the same time period, the average
cost per operative procedure has significantly dropped.
results of this technique are comparable to open surgery, but
postoperative pain and recovery time are dramatically reduced,
meaning patients go home sooner and return to their normal
activities much faster," said Dr. Sachs.
Singh, M.D., Dr. Bonner's surgeon, assistant professor of surgery
and MISCTE associate medical director, recently completed two
laparoscopic kidney removals from a donor to a living-related
transplant patient. Among the most common procedures performed at
the Medical Center using minimally invasive techniques are gall
bladder removal, hernia operations and a wide variety of spinal,
gynecological, cardiac, gastrointestinal and urologic surgeries.
Vascular procedures, cancer treatments and surgery on fetuses while
in the mother's uterus will be added to the list of minimally
Dr. Sachs said a patient undergoing a
spinal fusion, in which a damaged spinal disk is removed and
replaced by metal "spacers," would normally remain
hospitalized for 10 days and typically return to work in four
||the minimally invasive approach,
patients are discharged within one or two days and are able to
return to work in two to four weeks.
Dr. Bonner was
released from the Hospital later that day and was back to work the
following week. With traditional hernia surgery, he would have spent
several days in the hospital and would not have returned to work for
two to three weeks.
"He's a bit more motivated than most
patients," said Dr. Singh. "But he is certainly another
example of how minimally invasive surgery has improved outcomes."
New robot a key
component of MISCTE.
from Endobotics, Inc., an -engineering firm based at Rensselaer
Polytechnic Institute in Troy, have developed robot technology
that may eventually be used by physicians conducting minimally
invasive surgery at the Medical Center.
The technology was
introduced at the grand opening of the Medical Center's new
Minimally Invasive Surgery Center for Training and Education
With assistance from Albany Med surgeons,
Endobotics has taken the kind of precision that enables robots
to produce computer microchips and built a prototype robot to
perform the surgical tasks of cutting, tying, clamping and
suturing. The two-armed EndoBot uses endoscopic cameras,
ultrasound data, and tactile measurement for guidance as it
enters the body cavity through small openings - or ports.
can manually control the robot movements, or simply program the
robot to, suture a certain area and then supervise its actions.
Barton L. Sachs, M.D., M.B.A., associate professor of
surgery and MISCTE director, said the EndoBot has tremendous
potential to reduce surgery time, reduce costs, maintain quality
and decrease post-surgical complications. The EndoBot must
receive approval from the U.S. Food and Drug Administration
before it is used clinically.