In This Video
- Robotic and minimally invasive techniques enable surgeons to successfully complete more complicated procedures, including complex reconstructive surgeries
- Douglas Middleton Dahl, MD, is chief of the Division of Urologic Oncology and clinical co-director of the Claire and John Bertucci Center for Genitourinary Cancers at Mass General Cancer Center, as well as director of Robotic Surgery and a urologic surgeon in the Department of Urology at Massachusetts General Hospital
- Dr. Dahl explores the evolution of urologic surgery and highlights opportunities made available through advances in minimally invasive techniques
Douglas Middleton Dahl, MD, is chief of the Division of Urologic Oncology and clinical co-director of the Claire and John Bertucci Center for Genitourinary Cancers at Mass General Cancer Center, as well as director of Robotic Surgery and a urologic surgeon in the Department of Urology at Massachusetts General Hospital. In this video, he explores the evolution of urologic surgery and highlights opportunities made available through advances in minimally invasive techniques.
Urologic surgery has evolved dramatically in the last 10 to 15 years. In particular, minimally invasive surgery is allowing us to do far more complicated procedures and far more complex reconstructive surgeries with less invasive techniques.
Robotic surgery is part of an incredible advance in minimally invasive surgery. In urology we've been doing minimally invasive surgery for a long time; we can treat a lot of different procedures through the urethra and into the kidney without making any incisions. We adapted, and really urology was the first area to use robotic surgery widespread. It's probably still the major user of robotic surgery in any specialty.
Radical prostatectomy was pioneered as a minimally invasive technique. I was part of the group that started doing laparoscopic surgery 20 years ago. Robotic surgery has really enabled more surgeons around the country to be able to perform these complex procedures. We've been very involved with the development of and implementation of the newest models of the robotic instruments and finding the best uses for that.
We recently have upgraded to the latest versions of the robot, which really have improved efficiency, improved safety and allowed us to do more complex procedures more reliably. It's really been an exciting time to be able to offer these less invasive, very complex procedures to our patients, and robotics has been a big part of that.
What's amazing about the minimally invasive techniques is that you can get a small camera deeper into these spaces with greater magnification and greater control. Our assistants can see the same things that we're seeing. In many ways, you have to relearn anatomy because the view you have is so different than what you learned as a medical student doing dissections—even as a trainee in surgery during open surgery. We can be very creative about the approaches to how we manage things, to how the anatomy actually is a little different than maybe what we had learned.
So it really is a need creative opportunity to rethink some of the standard dicta of what we've been learning as surgeons is an amazing opportunity still with the technologies. We all know our phones are amazing. All the technology just changes dramatically. And there's the opportunity of linking the robotics with magnetic resonance imaging scans, with computed tomography scans, with guidance systems, with being able to look at things not just in the visible light spectrum, but with—we have already what we call green light magnification and highlighting. And there are just so many ways where these opportunities are going to meld very well with robotic surgery and with the technological platform.
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