Robot-Assisted Surgery Expands BACH Capabilities at Fort Campbell

FORT CAMPBELL, KY – Robot-assisted surgery may seem like something out of a futuristic sci-fi movie to some, but it’s actually a safe and increasingly common method that delivers better patient outcomes than traditional surgery.

“Before, it was a rare thing for [healthcare] institutions to have. They would be in very large medical centers, but now the technology is spreading to the rest of the medical community,” Major said.
(Dr) Morgan Barron, General Surgeon at Blanchfield Army Community Hospital, who was instrumental in bringing this capability to BACH.

Barron began performing robotic-assisted surgery over 10 years ago during his general surgery residency at Madigan Army Medical Center, Joint Base Lewis-McChord,
Washington. Additionally, the Institute for Defense Robotic Surgical Education, established at Keesler Air Force Base in 2017, has trained more than 100 surgeons and 200 other nurses.
operating room technicians for the Department of Defense and Veterans Affairs in robotic surgery team skills.

“It has a lot of broad applications, so we’re really excited to have it here. As a general surgeon, it’s something I’ve used for many years in other military treatment centers and it’s is simply fantastic.

How it works

Robot-assisted surgery is used for minimally invasive procedures. Unlike “open surgery” which involves cutting open skin and tissue to give the surgeon a full view of structures or organs
involved, “minimally invasive surgery” is a common technique that requires only three small incisions in most cases. An incision is for a small wand-shaped video camera which, when inserted, provides a
magnified view of what is happening inside the patient at the surgical site. This transmits a two-dimensional image which the surgeon views on a high-definition monitor above the operating table.
The other two incisions are used to insert the thin hand-held cutting tools, the size of a knitting needle, which the surgeon manipulates by hand to perform the operation.

“Typical minimally invasive surgery uses laparoscopic instruments that we call straight sticks. You stick them in and that’s about all you can do with them,” Barron said, twisting his wrists left and right to demonstrate the limits of his range of motion. “With a robot, you have full mobility of robotic arms that we can use.”

Robot-assisted surgery provides surgeons with better visualization and greater mobility. Robot-held instruments provide more precision and stability than traditional laparoscopy, Barron explained, and aren’t prone to the fatigue that a human might experience standing at an operating room table for a long period of time.

The robot-assisted surgical system is made up of three components. The robotic cart has a unit with four “arms” that hold the camera and surgical instruments. The surgeon’s console is where the surgeon sits in an ergonomic control console that directs the movements of the robotic arm. And the third component is a cart-like endoscopic stack that contains supporting hardware and software components, such as suction pumps and an electrosurgical unit.

“Once we have the robot in place next to the patient, we do all the robot control from a separate machine right there, near the patient, in the operating room. The console has 3D vision
Technology. So instead of just looking at a standard monitor, like a TV screen, I can actually look in three dimensions. It really helps my depth perception, and the controls really facilitate that wrist movement of the instruments,” Barron said.

New useful tool

The robotic system allows Barron to perform a wider range of laparoscopic procedures and patient benefits include smaller incisions, less postoperative pain, shorter hospital stays and faster recovery times. .

An example of his workload shared by Barron is hernia repair. A hernia is a condition, sometimes caused by muscle strain, heavy lifting, pregnancy, and even severe coughing, and may require
surgery to repair.

“For some abdominal hernia repairs, I would have to do a large open procedure that requires a long hospital stay, lots of painkillers, and longer recovery time. Now, patients can undergo the same surgery minimally invasively and have a very short recovery time. Most of my patients go home the same day,” he said.

Safe and common technique

Barron said he wants patients to know that robot-assisted surgery is very safe and common.

“It’s something I offer all my patients for certain procedures, but ultimately the choice is theirs,” said Barron, who walks his patients through all the options during their initial consultations. “I have used a robot in different institutions so far and my patients have had a lot of positive feedback. It can eliminate hours and hours in the operating room and delivers superior results.

Barron plans to offer the robot-assisted surgery option to BACH very soon, as the hospital awaits the final supporting components to bring the system fully online.

“It’s considered a kind of advanced surgical technology. It’s something that’s widely used, widely adopted, and increasingly becoming a necessary tool to perform certain operations,” Barron said. “We are very happy to be able to offer this technology here.”