Treasure Coast

Treasure Coast patients who require urologic surgery now have the benefit of receiving their care locally provided by an expert surgery team operating Martin Health System’s da Vinci robot.

“Robotic surgery is the standard surgical approach for many procedures in urology today,” said Dr. Adam Mues, one of Martin Health’s urologic surgeons.

Robotics, Mues noted, is especially helpful in surgeries that occur in small areas of the body, such as the pelvis, that are challenging to reach with hands or to see with the naked eye.

“Our main concern is patient outcomes, and robotic surgery has improved many of these outcomes,” said Mues, who joined Martin Health System in early 2015 after working as an assistant professor at New York University.

Outcomes have improved because of the minimally invasive approach, combined with the robot’s ability to perform difficult surgeries in an elegant manner, explained Mues.

“We are able to perform very sophisticated surgery in small, tight spaces that are difficult to access otherwise,” he said.

The surgeries are conducted through small keyhole-like incisions that produce less pain, less blood loss, and a reduced risk of infection and wound-related complications. Patients generally have shorter hospitalizations and experience faster recovery time and a faster return to normal activities.

“Another advantage of the da Vinci robot is an improved ability for surgeons to identify and treat complex conditions such as prostate cancer, kidney cancer and bladder cancer,” Mues said. “The system has an integrated fluorescence imaging capability called ‘Firefly.’ Firefly provides the surgeon with real-time, image-guided identification of key anatomical landmarks during cancer surgery.”

The robot includes a number of other features helpful to the surgeon. These include enhanced high-definition 3-D imaging for a high level of precision and control, a camera with a light at the end, and a pedal- and finger-controlled console where all robotic instruments and the camera can be manipulated by the surgeon with ease. The instruments have a “wristed” component with little joints that move, similar to a small hand.

“It’s a little bit like playing a video game,” Mues explained.

For that reason, the majority of robotic surgeries are being performed by a new generation of surgeons more comfortable with technology than their predecessors.

“It takes some getting used to,” Mues said. “You can’t feel the patient’s tissues, which is a major part of all open surgery. The dissection is done with visual cues only, using the tiny instruments manipulated from the control panel rather than your hand. You have to become very skilled and comfortable with learning how to feel the tissues with your eyes.”

Mastering robotic surgery involves extensive training. Mues completed his residency in urology at Ohio State University, which pioneered the early use of robotic surgery in urology, followed by a two-year fellowship in robotics at Columbia University in New York City.

“Robotic surgery is a great passion of mine,” he said. “It’s very gratifying to be able to treat these conditions in such a precise manner and to give the patient the best chance for an excellent outcome.”