York Hospital 'at cutting edge' of robotic technology

For some, putting trust in a robot might be daunting, especially when a life is at stake.

"You’re so used to seeing the surgeon at the operating table, and he's not," said WellSpan York Hospital President Keith Noll, describing one of the hospital's robot-assisted operations.

"It throws you off, " he said. "Why is the doctor in the corner?"

That's what York Hospital's most recent foray into robotic technology looks like. 

Physicians use a robotic arm to perform a cardiac stent procedure at WellSpan York Hospital on Tuesday, Nov. 7.

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A robotic arm performs a percutaneous cornonary intervention, a nonsurgical cardiac procedure to fix blocked arteries, while the doctor controls its movements from a nearby console.

York Hospital is the first and only hospital in the state to offer the procedure, according to a news release from WellSpan Health.

The technology was created by Corindus Vascular Robotics, which contacted Dr. William Nicholson, an interventional cardiologist at the hospital, several years ago to provide feedback on its development, Noll said.

The first generation of the robot came about two or three years ago, and the second-generation model, which came in mid-July, brought notable improvements, Nicholson said.

The robot can now control multiple pieces of equipment at the same time, and the movements made on the controls translate more easily to the patient, meaning the doctor doesn't have to get up as often to make adjustments at the table, he said.

Nicholson demonstrated the procedure on Tuesday, Nov. 7, and he said the hospital had completed 42 procedures with the new technology by the following Wednesday.

According to the news release, the second-generation model is the newest model available, which puts York Hospital "on the cutting edge."

"Early technology access has been a tradition for 15 years," Nicholson said, noting that WellSpan was one of the first sites to use TAVR valve replacements seven or eight years ago. The procedure allows physicians to repair the valve without removing the old, damaged valve, according to the American Heart Association. 

Dr. William Nicholson and others use the assistance of a robotic arm to perform a cardiac stent procedure at WellSpan York Hospital on Tuesday, Nov. 7. The robot is controlled from a remote console.

The hospital also is on its third or fourth generation of other surgical robots, Noll said. 

Nicholson and Noll said the hospital has not run into any problems with the cardiac or surgical robots, which Noll credits, in part, to close monitoring and rigorous testing. 

"Before we roll anything out we want to make sure we’re being safe," Noll said.  

He said each piece of new equipment is first tested in a simulation lab, which includes three operating rooms with mannequins serving as mock patients.

Nicholson added that the FDA closely follows the integration of new technology, and in the cardiac robot in particular, there are protective mechanisms so "the robot can't go rogue," he said. 

But even if those precautions don't work, Nicholson said, "at the end of all of it, the physician is there in the room and has hands on the controls."

Both agree that technology is part of the future of medicine.

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Nicholson said technology is an opportunity to mimic valuable skills, taking the best qualities from 10 different physicians and combining them into one.

Technology increases safety and accuracy, which provides better results for patients, Noll said, but he is not a fan of new technology for technology's sake.

"It has to bring value back from a clinical standpoint, and we’re pretty selective about what we use," he said.

In the next year, Nicholson said, he expects the cardiac robot will have more remote access to controls, so that a doctor could perform the procedure without even being in the same room.

The robot will eventually be able to do it without the doctor, Nicholson said, but "we're not there yet."

"It's going to be an entirely different world," he said.

— Reach Lindsay C. VanAsdalan at lvanasdalan@yorkdispatch.com or on Twitter at @lcvanasdalan