Contact: Karen Burbach, UNMC (402) 559-7377 or Kelly Grinnell, NHS (402) 552-2192 August 22, 2000

Ralston Man Praises Procedure
UNMC/NHS Completes First Surgery Using Robotic Equipment

The University of Nebraska Medical Center and the Nebraska Health System last week successfully completed its first abdominal surgery using its new robotic surgical equipment.

Ranjan Sudan, M.D., assistant professor of surgery, and Debra Sudan, M.D., associate professor of surgery, were co-surgeons on the Aug. 18 bowel resection surgery at NHS University Hospital. It was the first bowel resection surgery done worldwide using the da Vinci Surgical System equipment.

Last month, UNMC became the eighth U.S. medical center to obtain the da Vinci Surgical System equipment, developed by Intuitive Surgical Inc. UNMC physicians affectionately named the equipment "Chuck," in honor of Charles Durham and his late wife, Margre, who gave a major donation a few years ago to benefit three areas: arthritis, prostate cancer and minimally invasive surgery.

After extensive training, UNMC physicians scheduled their first abdominal surgery with Wray Crabill of Ralston. Due to an inflammatory bowel, the 64-year-old had been suffering from severe diarrhea and had lost about 85 pounds since January, going from 225 pounds to 140 pounds. Now recovering at NHS University Hospital, Crabill praised the minimally invasive procedure. "I feel really lucky to get a hold of this machine. It saved me a lot of misery."

Crabill admits he was initially skeptical about being the first person to undergo the robotic surgery but changed his mind. "The upside looked a lot better than the downside," said Crabill, who may be released as early as tomorrow.

Overall, the minimally invasive surgical equipment allows for a faster recovery, less surgical trauma to the patient and a three-dimensional picture for physicians, instead of the traditional, two-dimensional laproscopic view.

The surgery went extremely well, said Dr. Ranjan Sudan. "There were no complications or problems and the patient is doing very well. The surgery took a little longer than usual, but only because it was the first time."

During the six-hour surgery, doctors made five incisions -- the longest being 1.5 centimeters in diameter -- to remove about three feet of Crabill's small and large intestines and appendix.

"I'm very grateful for the university's support of the surgical department and the Durham family for having the vision to look for this type of technology for the medical center," said Dr. Debra Sudan. "It truly will change the way we do surgery over time."

Both Sudans recognized other members of the surgical team including staff nurses Missy O'Brien and Kathy Wonder and chief perfusionist Lance Fristoe. They also acknowledged Crabill for his willingness to be the first robotic surgery patient and Byers Shaw, M.D., chairman of the surgery department, for supporting the development of the technology at UNMC/NHS.

The da Vinci Surgical System consists of a surgeon's viewing/control console that has an integrated, high performance 3-D vision system; a patient-side cart consisting of three robotic arms that position and precisely maneuver endoscopic instruments and an endoscope; and a variety of surgical instruments.

The system translates the surgeon's hand, wrist and finger movements into corresponding movements of the instrument tips positioned inside the patient. Using the robot, the surgeon needs to make only tiny incisions, or ports, in the patient, instead of a longer incision needed for conventional surgeries.

Dr. Ranjan Sudan said stapling procedures were done laproscopically during the Crabill operation because the da Vinci currently doesn't have stapling instruments. The company is in the process of licensing the technology.

Without the da Vinci System, Crabill likely would have faced open surgery which would have resulted in a much longer recovery time, including no heavy lifting for six weeks, and a six-inch long scar, Dr. Ranjan Sudan said. It also may have presented other complications because the patient has emphysema.

Instead, Crabill was walking the hospital hallways only one day after surgery. He also had renewed physical strength. "I think it's a miracle if I'm out of here within a week after major surgery. When I checked in (Aug. 18) I was very weak and looked like a concentration camp prisoner."

Crabill spent 15 years working in a San Francisco hospital, first in dietetics and then in purchasing. About a decade ago, he returned to Nebraska after his parents died. He is retired and lives on Social Security.

Said Crabill, when asked if he would again choose robotic surgery: "I would recommend it, absolutely."