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W W W. M A I N E B I Z . B I Z 17 S E P T E M B E R 1 6 , 2 0 1 9 H E A L T H C A R E A third cart holds supporting hardware and software. Specialized instruments includes tiny "wristed" scissors, scalpels and forceps. e system translates the surgeon's hand movements, at the con- sole, to the instruments performing the procedure. e instruments move like a human hand and can fit through inci- sions of less than an inch. MaineGeneral acquired its first da Vinci system in 2009. is year, it installed a robot at ayer Center for Health in Waterville for outpatient surgeries and upgraded its robot in Augusta. For now, MaineGeneral is the only medical center in Maine that uses the surgical robot for emergency procedures. At Northern Light Eastern Maine Medical Center, in Bangor, Dr. Michelle Toder was an early adopter of the tech- nology. She and her team started doing bariatric surgery using a surgical robot in 2004. In 2017, Northern Light Eastern Maine Medical Center became the first Maine hospital to acquire a next- generation surgical robot. It now has three robots and will likely acquire a fourth next year. Maine Medical Center in Portland has three robots, acquiring its first in 2005. In 2016, York Hospital became the first hospital in Maine to offer robot-assisted partial knee replace- ment. Central Maine Medical Center in Lewiston is bringing in its first robot this October. Miniature hands "Robotics took off as the limitations of laparoscopy became more apparent," explains Toder, a general and bariatric surgeon and medical director of Northern Light Surgical Weight Loss. Like Reight, Toder was initially resis- tant to robotics. But she became con- vinced upon viewing its use in bariatric surgery. Now she's performed more than 3,000 robotic bariatric surgeries. In laparoscopy, she explains, the optics are provided by a single camera. "e image is two-dimensional, so there's no depth perception, and every- thing is reversed," she says. "It's like looking in a mirror." Laparoscopic instruments are essen- tially long, skinny sticks. e working parts open and close and can be rotated 180 degrees in either direction. "It's not a super dexterous tool," she says. "In the body cavity, nothing's actu- ally linear. You're coming at all those organs with sticks that don't bend like a hand would." e robot-assist system has two cameras in one scope, essentially a left and right eye. e computer stitches the images together as a high-definition corrected picture. e robotic "hands" have the same degree of freedom as human hands. "e motions you make with the instruments feel exactly like your own hands," Toder says. e da Vinci system has evolved over the years. "Like all electronics, everything is smaller and more user friendly, and there's a broader platform of instru- ments," she says. Because of the tiny incisions, post- surgery benefits are significant. "Patients find that surgeries per- formed with the robot require less pain medication and fewer compli- cations, and they are able to return home sooner," says Reight. ere's also less chance of having to convert to open surgery, he adds. In a comparison of robotic versus laparoscopic colorectal surgeries, MaineGeneral found laparoscopic pro- cedures were converted to open surgeries 28% percent of the time, compared with only 8% using robotics. NEW EMPLOYMENT LEGISLATION will have significant impact on most businesses • What effect will these new laws have on your business? • What do you need to do to prepare? • Are your employment policies consistent with these changes? Our experienced attorneys can help. Contact us today. 207.947.4501 rudmanwinchell.com C O N T I N U E D O N F O L L OW I N G PA G E » At Northern Light Eastern Maine Medical Center, in Bangor, Dr. Michelle Toder was an early adopter of robotic technology. F I L E P H O T O / C O U R T E S Y O F E A S T E R N M A I N E M E D I C A L C E N T E R Shifting to robotics C entral Maine Medical Center in Lewiston is the latest Maine hospital to roll out a da Vinci surgical systems robot, for applications including urology, bariatrics and gynecology. The purchase is the most recent development in the growing surgical service. In the past year, the system has hired new surgeons, re-aligned duties and invested in facilities and technology to provide a broader range of services to all its locations, including Bridgton and Rumford hospitals and the Topsham Care Center. Much surgery continues to take place at CMMC, but updated schedules and rotations make surgeons available for consultation, pre-op visits and follow-ups at more locations. Surgical patients in the Lake Region, for example, no longer have to drive to Lewiston for every visit. F O C U S

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