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Surgical Robot Offers Improved Patient Outcomes in New Specialty

When the da Vinci® Xi™ Surgical System was brought to Skagit Valley Hospital in 2018, Skagit Regional Health became the first healthcare system north of Everett to offer the latest model of the advanced, robot-assisted technology. Due to the increased precision of the tiny instruments, it allows surgeons to successfully perform more minimally-invasive procedures, which affords many patients reduced recovery times, shorter hospital stays and overall improved patient outcomes.

Gynecologists are the latest specialists to begin using the robotic system at Skagit Regional Health, joining colorectal, general and thoracic surgeons.

Dr. Halvorsen and Dr. King

“A lot of organizations that originally were using robotics started in general surgery because they did a lot of laparoscopy, but then the urologists found that the robot actually gives you a lot of dexterity in tight spaces, such as the pelvis,” said Carlyn King, DO, Women’s Health provider at Skagit Regional Health. “It naturally followed that gynecologists would be interested by this advance of surgery in the pelvis so we adopted it into our specialty and began using it to help women with various conditions in the pelvis.”

Trisha Halvorsen, MD, at Skagit Regional Health, said she believes this new technology will change how we approach gynecologic surgery in an extremely positive way. “I think having the robot is really a game-changer,” said Halvorsen. “This is a benefit to our community and the fact that our administration was willing to invest in that at the request of the surgeons speaks volumes of the people who run our organization,” said Dr. Halvorsen. “I’m really excited to be able to use that technology, to offer that to my patients, to improve patient care and patient outcomes with this great device we have.”

The robot allows Dr. King and Dr. Halvorsen to perform a variety of gynecologic surgical procedures such as hysterectomies, pelvic organ prolapse, challenging ovarian cysts and surgeries for endometriosis. It even allows them to perform procedures not possible through more traditional methods.

“It helps me provide complex surgery to women who might not be candidates for surgery here otherwise,” explains Dr. King. “With traditional laparoscopy, you don’t get to do a lot of the more complex surgeries. That’s because the drawback of traditional laparoscopic instruments is their limited range of motion. The robotic instruments have a much greater range of motion due to their design, so the da Vinci robotic system allows me as a general gynecologist to really expand my repertoire of gynecologic surgery and be able to provide care for patients in our hospital without having to travel down to a faraway city for care.”

Dr. King was instrumental in bringing this technology to Women’s Health at Skagit Regional Health.

“I found that more and more of my patients came to me with really complex problems and had a history of multiple surgeries, or people have tried to help but never were able to be successful before for some reason or another,” said Dr. King. “Those patients, I felt, needed more technology, more support, more surgical services to be able to treat them. I realized at that point that a lot of my patients would benefit if I had an additional skill set and was able to advance my surgical skills to help them. So I started looking into robotics and we started a whole training program here. I got trained fairly quickly on it because of my experience operating with the da Vinci system in residency. Then we launched our GYN robotics program a few months later.”

The training involved in becoming certified to use the robot is rigorous. Dr. Halvorsen agrees the robot offers tremendous benefit to our community, increasing our capabilities for keeping patients within the Skagit Regional Health system for high-quality treatment.

“Any patient can benefit from the advantages of robotic surgery,” said Dr. Halvorsen. “In the past, if I had a patient who I recognized would not be a candidate for traditional laparoscopic surgery due to the surgical complexity, but felt that they would be a candidate for surgery robotically, I would transfer those patients out of our community to a tertiary care facility,” said Dr. Halvorsen. “Now, with having robotic technology here, we’re able to offer certain surgeries that we couldn’t have offered in the past. It’s a great thing to be able to offer our community.”

For patients who may feel hesitant about allowing a robot to be used in their surgical procedure, Dr. Halvorsen offers reassurance that the surgeon actually gains better control of the surgery than a traditional method and the benefits of that translate to a better patient experience.

 “It’s not the robot performing the surgery. It’s the surgeon performing the surgery,” explains Dr. Halvorsen. “The robot is really just a tool to allow me to complete the surgery in a safe and efficient way, to give me better visualization, and to give me better control of my instruments.”

Dr. King adds, “I feel confident in my surgical skills in general. Adding a new tool that actually allows me to use my skills more efficiently was fairly seamless. It felt like I was physically more capable with using this technology and I really enjoyed that. I realized, ‘This is the tool that’s going to help me help my patients.’”

Not only does it allow the surgeon a better surgical process, there are multiple benefits to the patient, including a shorter hospital stay and significantly improved recovery time.

“Our patients can go home the same day after a hysterectomy which is amazing,” said Dr. Halvorsen. “Most of our patients are up and running again within 7-14 days. They may still be sore and fatigued, but are typically off all narcotic pain meds within 1-3 days. Whereas with the traditional big incision…those patients may spend 3-4 days in the hospital and often require pain medications for quite a bit longer. During that time, mobility can be a challenge, mostly related to pain and discomfort.”

Skagit Regional Health remains committed to transforming healthcare by improving access, service, quality and efficiency.

“The whole driver of starting to use the robot in GYN surgery is that our patients will benefit from this,” said Dr. King. “There will be patients who can now have surgery here who couldn’t before.”