Medical professionals want to provide the best possible outcomes for their patients.
For three Froedtert South surgeons, this means sharing their expertise in the latest technology with their peers outside of Kenosha County.
Over the past few years, Dr. Joya Raikar, Dr. Majid Jandali and Dr. Mustafa Pedroga have successfully used robots to perform procedures at Froedtert South Pleasant Prairie Hospital.
Using the da Vinci Xi robotic system, Dr. Badrudduja and Dr. Jandali perform abdominal surgeries, hernia repairs and Dr. Raikar performs a wide range of heart and lung procedures.
Froedtert South acquired a first-generation da Vinci robot from Intuitive Surgical in 2006, and moved to the fourth generation of robots in 2015. The hospital now has three fourth-generation robots. Dr. Jandali and Dr. Badrudduja started performing robotic as well as minimally invasive (laparoscopic) surgery in 2015.
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“Da Vinci was originally designed for cardiac surgery, but the learning curve was so steep that its first uses were in urology and general surgery,” notes Dr. Raykar.
Using the robot, Dr. Jandali and Dr. Pedroduja perform all different types of hernias from simple to complex recurrent hernias, gallbladder, weight loss surgery, colon intestinal surgery including cancer, reflux surgery and removal of solid organs such as spleen and adrenal gland.
Dr. Raykar, who has been with Froedtert South since 2019, has worked in robotic surgery since 2005 in Minnesota. “I had the first robotic mitral valve operation in the state; there were only a few of us trying it at the time.”
Dr. Raykar’s robotic procedures currently include coronary value repair, tricuspid valve repair, coronary artery bypass grafting, heart tumors and congenital defects.
“The world of robotics has exploded across the board but in the world of cardiology (Frodert South) it still has the only program in Wisconsin,” said Dr. Raykar.
Monitors and mentors
As each of these surgeons became proficient in technology and robotic procedures, they began inviting them to share their knowledge with surgeons across the country.
This was done via two methods. Surveillance centers offer surgeons interested in robotics a place to come and observe robotic procedures. This leads to the second method which is observation, in which Froedtert South surgeons travel to different hospitals to assist other surgeons with their first robotic procedures.
Dr. Raykar became a robotic controller for other surgeons in 2007 in Minnesota. “Frodert South is a unique institution and (robots) was one of the things that drew me here,” he said.
Dr. Jandali and Dr. Padruduja began observing others for robotic use in hernia and abdominal surgery in 2016. Since then, they have monitored in several places including Chicago, Michigan, Wassau, Dakota, Minnesota, and Pennsylvania.
Surgeons are also oriented to the doctors they call for advice on robotic surgery, notes Dr. Badrudduja. “As an observer, I am kind of an observer and may make suggestions,” he said.
Soon after Dr. Jandali and Dr. Bedrodja began robotic surgery, Froedterter Pleasant Prairie Hospital was identified as a high volume robotics program and began providing feedback to surgeons across the country, including such prestigious institutions as UW-Madison, Loyola, Mayo Clinic and Johns Hopkins .
Dr. Badrudduja started observing surgeons at other medical facilities starting in early 2016 and began providing feedback to other surgeons at Froedtert South in 2018.
“When the monitors come to Froedtert South, Dr Jandali and I try to schedule a full day of procedures so that surgeons can see the robot in a variety of applications,” said Dr. Badrudduja.
“There is nothing better than seeing (robot surgery) in action and seeing how the day flows,” said Dr. Badrudduja.
Kudos to the Froedtert South team – they make (using the robot) look so easy,” said Dr. Raykar.
Freudert South Pleasant Prairie Hospital is unique. “There are one or two other places (in the country) that can provide surgeons to monitor performing surgeries using a robot,” said Dr. Badrudduja. Dr. said.
To help fellow physicians feel comfortable with robotics, Froedtert South surgeons highlight the advantages of the technology: ease of procedure, improved visual field and versatility, reduced pain for patients, and a shorter hospital stay.
One of the first areas of success in robotic surgery, surgeons say, has been hernia repair.
The graceful tip of the robotic machine, or “wrist,” is capable of making precise stitches. Dr. said.
“By using robots, you can also get into hard-to-reach places,” he added.
Robots may also extend surgeons’ jobs because robotic procedures place less physical stress on surgeons. Where traditional surgeries require surgeons to stand for long periods of time, robotic surgeries are performed from a sitting position, said Dr. Al-Jandali.
“Once you have the robotic procedures done, you don’t want to go back,” Dr. Raykar said.
Encouraging the benefits of robotics also sometimes means dissuading peers from misconceptions surrounding the technology. Dr. said.
“There is a misconception that[the use of robots]is slow and disrupts[the schedule for surgery],” said Dr. Badrudduja. We want to show that this is not the case at all. It’s just as effective.”
Before they are paired up with a Froedtert South surgeon, the robotic surgical teams undergo rigorous training that includes educational modules, simulators and testing.
“Robot surgery has a steep learning curve,” said Dr. Jandali.
“Everyone should be easy to handle (all aspects of) the procedure,” said Dr. Raykar. “It’s not a weekend course.”
Surgeons interested in pursuing robotic procedures begin with a visit to an observation site offered at Prairie Freudterte Hospital South Pleasant.
After that, they return to their local hospitals to take simulation courses offered by the robotics manufacturer.
Dr. Al-Jandali explained that “the training includes device safety in addition to computer simulation for 20 hours in addition to a two-day course using cadavers with an observer for the first three cases you perform.
“This technique involves the use of hands and feet. It’s like driving a pickup truck,” Dr. Al-Jandali said. “Some go through all the (training) and decide it’s not for them. They must have a commitment; to believe in him.”
Satisfaction with sharing
Froedtert South surgeons say it is satisfying to help fellow surgeons master new technology.
“I would love to show them how we can perform advanced and challenging cases using robotic surgery,” said Dr. Jandali. “Ultimately, I believe in this technology and would like to see it succeed more,” said Dr. Jandali.
“What I love about observing other doctors in robotic procedures is sharing and learning from other surgeons and feeling so proud that places like San Diego now have the option to use robots,” said Dr. Raykar.
increasing of demands
“As of today, (Froedtert South) has performed more than 5,000 procedures using robots,” according to Dr. Jandali’s report, who noted that he had performed 2,800 of them.
Dr. Padruduja said that the demand for robotic surgery has grown with the expansion of the types of specialties in which it is used. “Who knows where this will be in ten years?”
“Robots are becoming the next generation of standards of care,” Dr. Raykar notes.
“Robots will only improve what we are already doing well,” said Dr. Badrudduja.
it has an effect
It’s not uncommon for emerging technologies to start in smaller communities and fans to spread to larger institutions, says Froedtert South surgeons.
“Surgeons come here to see and help bring technology back into their communities,” Dr. Badrudduja noted. (Our guidance/monitoring) is an example of how community hospitals are impacting major medical centers.” “I want my patients to have better surgical experiences and better outcomes. (I can do it better with) being able to share this technology and help colleagues overcome misconceptions they may have,” said Dr. Badrudduja.
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