Pediatric Robotic Surgery

Robotic Surgery: Making Big Surgeries Easier for Little Patients

It is 7:30 a.m. on surgery day and Scott and Casey Laird are handing their groggy, four-month-old son Kort over for surgery. As is customary at Our Lady of the Lake Children’s Hospital, Kort isn’t wheeled to surgery on a gurney or a wheelchair. He is simply carried by a nurse or child life specialist.

Scott and Casey shower Kort with one more flourish of kisses before handing him to the nurse. Surgeons will spend the next several hours performing a delicate operation to remove an improperly developed lobe from one of Kort’s lungs. Unlike the vast majority of such cases nationally—and all other such procedures within the region—it will be performed using an advanced robotic system.

“Any case we can do minimally invasively will have improved recovery time,” says Kort’s surgeon, James Wood, MD, of Pediatric Surgery of Louisiana.

With Kort prepped and sedated, Dr. Wood takes his seat at the controls of the da Vinci Si, a leading robotic system for pediatric surgery.

Dr. Wood puts the robot through its paces. With articulated joints and wrist-like fittings that grip the instruments, the robot is even more agile and flexible than a surgeon’s hand.

The surgical team’s mission is to remove a lobe of Kort’s lung where some of the tissue didn’t develop properly while he was in the womb.

The procedure will require three tiny incisions, none of them much more than an inch wide. Through those slits the surgeons will insert and deploy all the miniature instruments and optics of the da Vinci Si system.

At his console, Dr. Wood manipulates fingertip controllers that correspond to the exquisite movements of the surgical instruments. He scrutinizes everything on a built-in, high definition video screen. His surgical partner John Lopoo, MD, and other surgical staff attend to Kort at the bedside. “Robotic pediatric surgery is very much an innovative field that is still developing,” Dr. Wood explains. Our Lady of the Lake houses two of the daVinci systems, the Si and the Xi, the latter of which is the most advanced robotic system available.

For Kort, it will mean a shorter recovery time and less surgical scarring thanks to the tiny incisions. Most infants with the same condition are operated on at three months old, which is just barely too small for robotic-assisted surgery. But an upper-respiratory infection delayed Kort’s surgery enough to make him an ideal candidate for this less invasive option. For parents Casey and Scott, it was an easy choice. They learned about the irregular tissue in Kort’s chest in utero when it showed up on an ultrasound. “Dr. Wood let us decide which we’d rather; we said whatever was easier,” Scott says.

Dr. Wood started training in robotic-assisted surgery when he was a medical resident at the University of Colorado Denver School of Medicine. He received further training during a pediatric surgical Fellowship at the University of Texas Southwestern Medical Center in Dallas.

Roughly five hours after the Lairds put Kort in the nurse’s hands, Dr. Wood joins Casey and Scott in a consultation room bearing good news. The surgery was a success, there were no complications and Kort will soon make a full recovery.

The Lairds had known little about robotic assisted surgery until Dr. Wood suggested it for Kort. Though he was healthy for the time being, without surgery Kort’s condition would have worsened as he grew. Thanks to Dr. Wood’s clear explanations, the Lairds said they felt confident about Kort’s surgery.

“The scariest part for me was how to care for the incisions, how to deal with that after surgery,” Scott says. “But they were so small and so seamless, they really were maintenance free.”

“He had surgery on Friday; we were home on Saturday evening,” Scott continues. “No one really likes to have to go to the hospital, but the way they treated us—and more importantly, the way they treated Kort—was fantastic.”

Read the full story in Amazing