Friday, June 25, 2010

Urological Impressions episode 2 - The daVinci Wars

Hi everyone, it's been another week down at the OR (operating room) and meeting patients with my mentor Dr. Douglas Scherr of Urology. This week has not been as hectic as it was when I first arrived, probably because I have gotten adjusted to the scenery of the hospital. Anyways to prevent the unfortunate readers of this blog from being bored to death reading long entries every week, I will keep this one (and hopefully the coming ones) short and straight to the point highlighting the events that I found particularly interesting or relevant.

This week I was finally able to view the da Vinci Surgical System, which I shall refer to as the daVinci, which is a large robot composed of two parts: one parts resembles a large spider with many arms and a second part which looks like a small cube. The part with the arms contain the surgical instruments and tools that are controlled remotely by the medical doctor from the small cube. What I found interesting was that after the cameras and arms are inserted into the patient, a 3-D projection of what the cameras see is projected into the cube allowing the doctor to have depth perception. The daVinci allows excellent control and responsiveness to the doctor utilizing it as well as a magnified view of the inside of the patient. I would also like to mention that the procedures involving daVinci is minimally invasive which allows faster healing for the patients in comparison to open surgery. I watched a robotic radical prostatectomy using the daVinci which removed a benign prostate tumor from a patient about the size of a mandarin orange (compared to healthy walnut size) after which they performed anastomosis (reconnection) on the urethra and bladders. Another surgery I've seen was a robotic radical cystectomy on a male with T2 bladder cancer where his bladder, distal ureter, seminal vesicles and prostate were removed via daVinci. Afterwards they created a neobladder or fake bladder from a section of the ileum which they modified into an elliptical shape, which was then reconnected to the urethra and ureters.

In other news I attended a Grand Rounds on Mon. where a doctor presented some case studies involving urodynamics. In the Grand Rounds the doctors would show some real patient cases and then question the residents on what their diagnosis would be given the information. I watched a cystography where the doctors put their patient under general anethesia and removed a bladder tumor from the inside with a resectascope. I've also watched an interesting case where a patient was under a CT scan and the doctors discovered, to their shock, that she was missing a large portion of her right ureter which would require surgery on her part.

As for my research, my mentor still needs to get in contact with my research advisor back at Ithaca before we can make more progress. In the mean time I looked up information involving calcification and stone formation in the bladder; I've discovered that GAG's naturally inhibit stone formation and that heparin coated materials also do a similar job. For now I plan to do some more literature search on my own and hope to make progress on this potential project very soon.

Stay tuned for episode 3 of Urological Impressions next week...

No comments:

Post a Comment