Most people who undergo surgery don’t comprehend the precision and skills doctors use because they don’t witness it. Emerging technology makes operations less invasive and more exact, and people in Brookings become familiar with a new tool in an unlikely place.
South Dakota State University student Nathan Willen just wants to purchase some groceries, but a gigantic machine settled between the aisles lures him to a seat. He presses his eyes against the façade. He slips his hands into controllers. Six feet away, robotic arms swivel, delicately manipulating a penny with miniature pinchers above brightly-colored cones.
"If I make it through vet school, I doubt I will ever use something like this, but very neat, very amazing to see what they actually use on perhaps me someday," Willen says.
Willen runs a robot. He’s inarguably part of a generation that grew up with video games, so he has an advantage with hand-eye coordination concepts. But the Belle Fourche native has a familiar South Dakota analogy for the machine.
"If you think of like a farmer in a tractor. I mean, he’s running the grapple and can run the bucket from 10 feet away – kind of the same thing, but just it’s surgical equipment," Willen says.
"It’s a lot different when you’re operating on humans, of course, compared to playing games with rings and pegs," doctor Ellen Hopper says.
Hopper is an OB/GYN in Brookings. She operates using the robotic instruments. Hopper says she wants patients to know as much as they can about their health. That’s why she’s pleased that people are pausing to run the robot and experience a little bit of her job. Surgeons use robots in more operations now – for instance, gallbladder surgeries, colon operations and hernia surgeries. Hopper says robots offer her patients alternatives that are less traumatic than traditional surgery.
"It’s a great option for hysterectomy, for endometriosis-type surgeries, for removing ovaries," Hopper says. "The key is that it’s minimally invasive; you have the small incisions compared to the big incisions that you otherwise would had in the past which helps with recovery."
The Avera doctor performs procedures at the Brookings Health System. When Hopper started in Brookings, robots weren’t available. Now she uses state-of-the-art tools in many of her surgeries.
"It makes the technology easier to use," Hopper says. "Two-dimensional laparoscopy is a lot more difficult than robotic, so this opens up minimally-invasive surgery to all patients."
Hopper’s colleague, general surgeon Theresa Oey-Devine, elaborates on the distinction between robotic tools and laparoscopy, that is, instruments positioned at the end of long rods.
"The main difference for using the robotic technology is, not only the 3D imaging that we’re able to see on the screen – it makes things a lot clearer, but also because the instruments we use have wrists inside," Oey-Devine says. "It’s like having tiny little hands working on the tissues instead of just the long trocars that we have to torque a lot more."
That means the robotic technology articulates the same movements a surgeon’s hands and arms make, which offers a more natural operation. It also allows doctors to complete more delicate work without causing unnecessary trauma to the body.
"A lot of times, surgery is a very mystical profession because the patient goes to sleep and then they wake up and their gallbladder is gone or their appendix is gone or their uterus is gone," Oey-Devine says. "So this allows them to kind of understand more of what we’re doing in the operating room."
Joe Mendel has been in that operating room, and he’s pretty sure he’ll be there again.
"You know, I’m 73 years old, and my body parts are wearing out," Mendel says. "I’ve had several already, but in the future I’m probably gonna need some of the expertise of this machine."
Mendel has no medical background; he worked at 3M for 25 years. And this retiree is impressed with the technology literally at his fingertips. He instantly maneuvers a tiny green ring onto a sharp yellow thorn.
"I thought it was very, very easy to operate and very precise," Mendel says.
Shopper after shopper who runs the robot uses that word: easy. So I have to try it. I press my face against the viewfinder and slip my index finger and thumb into the controls below. I move my hands inches forward, but the machine scales those gestures down so the robotic arms move millimeters among the tiny spikes.
"They still need to know that there are surgeons actually doing the work, and it's not just a robot doing the work," Theresa Oey-Devine, M.D. says.
My movements are smooth and exact; the pinschers are steady and specific. Little kids walk by in awe, and the robot astonishes people generations older.
General surgeon Theresa Oey-Devine says the technology is incredible, but the demonstration lacks an important asset to real operations.
"A lot of people going through the grocery store and being able to use this is great," Oey-Devine says. "But they still need to know that there are surgeons actually the work, and it’s not just a robot doing the work."
Dozens of people stop their shopping to sample the robotic technology. Physicians hope the up-close opportunity offers patients hands-on confidence in their health care.