Surgeon Stephen Noble sat at a console a few feet away from the operating table, his head inside a viewing box that displayed a three-dimensional image of a patient’s chest.
With his hands on two controllers, four robotic arms moved in tandem on the other side of the room. Each arm slipped through a port no wider than a fingertip to reach a tumor deep inside the lung.
This is what lung-cancer surgery looks like with the new Da Vinci 5, the latest robotic platform now in use at Chesapeake Regional Health — the first hospital in Hampton Roads to bring the fifth-generation system into the operating room.
“It really allows us to do things in such a way that we can remove a portion of their lung or a whole lung with very small incisions, which really translates into a return to their normal activities, a shorter length of stay in the hospitalization,” Noble said.
The process begins with marking five small ports along the side of the chest. Those tiny openings become access points for robotic instruments and cameras.
Once the ports are placed, the team docks the robot to the patient, attaching each arm to a port so the machine can operate inside the lung cavity while the surgeon works from the console.
The system’s internal camera provides a magnified, three-dimensional view of lung tissue and blood vessels. That allows surgeons to perform complex procedures through small ports instead of a large incision.
The newest Da Vinci platform also adds “force-feedback,” giving surgeons the ability to feel resistance as they touch tissue – a major upgrade from earlier generations.
Noble said the system feels similar to playing a video game, with controllers that vibrate when they make contact.
To use the Da Vinci 5, surgeons undergo online coursework, simulator exercises and cadaver or animal-based training. Their first clinical cases are performed under the supervision of an experienced proctor to ensure safety and technique.
“A lot of that learning curve is just troubleshooting the robot, trying to set it up just appropriately,” Noble said.
The impact for patients, Noble said, is substantial.
He said smaller openings mean less trauma, fewer complications and shorter hospital stays.
Traditional open-chest surgery requires a long incision and often keeps patients out of work for up to eight weeks. With the robotic approach, Noble noted, many return home in one to three days and resume normal activities within two weeks.
Inside the operating room, the robot’s compact footprint frees up space for staff, while its real-time analytics help teams monitor performance and safety throughout the procedure.
“There is an exponentially more amount of computing power or analytics that really provides surgeons and their teams a lot of data in regards to how they can improve efficiency, effectiveness, as well as some quality control measures to improve safety,” Noble said.
The system is a major investment for Chesapeake Regional. Chief Executive Officer Reese Jackson said an advanced surgical robot typically costs more than $1 million to start. Ongoing staffing, training and maintenance are “not particularly troublesome” expenses compared to the initial purchase.
He said the investment aligns with a larger strategic shift as more surgeons adopt robotic approaches because of their benefits for patients.
“While there are strategic considerations,” Jackson said in a statement sent to WHRO, “the investment in robotics is chiefly for patient care, which is worth the expense.”
Noble believes future versions of the platform could support telesurgery, allowing specialists to operate on patients in rural communities where access to hospitals is limited or even during humanitarian missions overseas.
“The hope is that we can really extend this platform, this treatment, this innovation, to individuals in remote and rural areas,” Noble said.
