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8 | Health Matters: Providence St. Jude Medical Center Sometimes, Precision Is Everything H ome to one of the state's most comprehensive and respected minimally invasive and robotic-assisted surgery programs, Providence St. Jude surgeons are elevating patient outcomes in areas from gynecological cancers to GERD—while leaving behind incisions that can be covered with a Band-Aid. Inside the hospital's surgical suites, you'll find the ExcelsiusGPS Robotic Platform, da Vinci Robotic Surgical System, and the da Vinci's new Ion platform for minimally invasive lung biopsy. These technologies translate a surgeon's hand movements into smaller, more exact movements, and offer high-definition imaging with exceptional views of the surgical site, often allowing surgeons to differentiate between diseased and non-diseased tissue more easily. The result is a long list of advantages for patients, including fewer complications, significantly less pain and blood loss, and a much faster recovery. "We're using robotic-assisted surgery to not only reduce the invasiveness, pain and trauma of surgery but to create more precise and successful treatment," explains Daniel Oh, MD, a Harvard-trained and nationally respected thoracic surgeon who trains physicians from around the world on robotic lung surgery. LUNG Most lung cancer surgeries in the U.S. are still per formed using an open thoracotomy technique resulting in over a week in the hospital and often months of pain. Providence St. Jude is at the forefront of creating a ver y different scenario, where robotic-assisted surger y is used to remove lung cancer through a few tiny incisions, resulting in better outcomes, less pain and a much shorter hospital stay. " Until now, sur vival rates af ter lung cancer surger y have not improved in decades," explains Dr. Oh, M.D., Medical Director of the S t. Jude Center for Thoracic and Esophageal Diseases and among the first in the nation to routinely per form robotic lung cancer resection. "Robotic surger y is allowing us to finally change that, by giving us the tools to more completely and aggressively remove the cancer." One of only six hospitals in the western United States designated a center of excellence in robotic lung resection, the hospital 's physicians are also using robotic technology to improve the accuracy of lung biopsies, while accessing formerly "hard to reach" nodules or masses. PANCREAS Surgical resection of pancreatic cancer—called a Whipple procedure—is one of the most complicated and technically challenging surgeries per formed, and our highly experienced hepatobiliar y surgical team is one of only a handful of hospitals in California with the expertise to use robotic techniques to dramatically reduce its invasiveness. " The robot 's enhanced vision, precision, and control are all important advantages in transecting and reconstructing the pancreas," says Maria Stapfer, MD, who leads the pancreatic cancer surger y program. Because the robotic wrists are capable of rotating over 500 degrees in multiple directions, it creates a dexterity that far exceeds the human hand. Meanwhile, the robot 's near-infrared imaging allows surgeons to more clearly assess anatomical structures and tissues—without the long incisions and weeks of recover y often required by pancreatic surger y. " We're focused on across-the-board improvements in outcomes, from using pre-surger y therapies to improve resectability, to using robotic-assisted techniques to reduce trauma and accelerate recover y," explains Dr. Stapfer. In addition to pancreatic cancer, the hospital 's hepatobiliar y team is using the robot 's capabilities to improve surgical options for liver cancer, chronic pancreatitis, bile duct cancer, and others. SPINE At Providence St. Jude, back surger y is being transformed into a minimally invasive procedure. And as the state's only designated center of excellence in robotic spine surger y, physicians throughout the U.S. are coming to St. Jude to learn how. "Surgeries that typically require four to five days in the hospital are often reduced to an overnight stay," explains Erick Westbroek, MD, who routinely uses robotic-assisted surger y to treat degenerative disease, herniated discs, scoliosis, ner ve compression, and spinal tumors. Aided by a state-of-the-ar t GPS navigation system, the hospital 's spine surgeons bring pinpoint accuracy to accessing the spine. "Eliminating the need to remove the muscle from the spine is a game- changer in terms of pain and recover y," explains Dr. Westbroek, a Stanford-trained neurosurgeon who completed his fellowship in complex spine surgeries at Johns Hopkins Hospital. "Because those muscles stabilize the spine, leaving them in place offers far better shor t-term and long-term outcomes." 3D modeling allows surgeons to preplan exact hardware placement before surger y, while the robot 's image guidance system designs the ideal trajector y. Robotic navigation, says Dr. Westbroek, moves surgeons as close to per fect accuracy as possible: " We're leveraging technology and exper tise to create extraordinar y outcomes for patients."

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