UNMC surgeon explains robotic technological advances

In the movie "Fantastic Voyage," a paragon of '60s science fiction, a group of surgeons are shrunk down to microscopic size and sent to perform brain surgery on a diplomat who was the victim of an assassination attempt. Though laced with dark humor and hilariously cheesy special effects, at its core, it's not such a silly idea. "We still have a little ways to go before we are shrinking each other," said Dmitry Oleynikov, an associate professor of surgery and the director of the Center for Advanced Surgical Technology UNMC. "But we can shrink our instruments and our tools."

About 90 people made their way to the Slowdown on Nov. 10 to hear Oleynikov speak about the future of robotics in the field of medicine

Through recent developments in medical technology, Oleynikov and his colleagues have been at the forefront of videoendoscopic developments. Videoendoscopy is surgery performed with the guidance of a camera on the end of a long tube, which is inserted into the body to examine interior organs.

They are now able to perform complex surgeries through much smaller incisions, and in some cases, no incisions at all. Standing in front of a projection of C-3PO from "Star Wars," Oleynikov showed a video of two robotic arms cutting away at a growth near a patient's liver.

Both the mechanical arms and the camera fit within a hole no larger than a quarter, allowing Oleynikov to perform whatever removal is needed. All the patient needs after surgery is a Band-Aid, decreasing both pain and recovery time.

All of this is made possible by the da Vinci Surgical System- a pair of arms equipped with various kinds of scalpels, knives, clips and a 12 mm camera. It provides real-time video for manipulation of tissue. The system uses two joysticks, much like an arcade game.

Oleynikov said using the da Vinci is like driving an automatic transmission after only driving a stick all your life. While it takes getting used to, not much skill is needed. However, UNMC only lets those with at least 12 years of experience touch the controls.

A member of the crowd asked if such advancements would eventually remove surgeons from the equation of surgery. Oleynikov said that we are still very far away from machines doing surgery independently.

"I joke that this machine has less automatic functions than a toaster," he said. "Because as soon as I step away, the machine stops. A toaster at least has a timer built into it. The machine only does what I tell it to do, nothing automatically happens."

He showed another surgery involving an artery being removed from someone's chest with a still beating heart. The technology allowed Oleynikov to perform a bypass through very small incisions. He views this as a testament to how far the medical field has come in technological advances since the '60s.

A future technology currently in production is a small 5-inch device that can be controlled remotely. It is inserted directly into the patient's mouth to look for cancerous growths and may even be helpful for monitoring the healing of bone or tissue. The video showed such a metallic rolling pin shaped robot rolling over the hills of intestines in a dog.

Oleynikov said he has high hopes for the future of research and development of robotics in medicine, comparing upgrades in medical technology to the advancement from record players to iPods.

"Before we had these devices," he said, "it was always just a surgeon with a piece of sharp steel in his hand.