By GARY DEMUTH

Salina Journal

"Fun" is not a word Dr. Christopher Graber would ordinarily use to describe major surgery.

But after the Salina obstetrician/gynecologist used the new da Vinci Surgical System at Salina Regional Health Center to perform a number of hysterectomies, it seemed like an accurate description.

"It's like a big video game, but it's to the patient's benefit," said Graber, a partner at Salina Women's Clinic, 135 E. Claflin. "It's really a revolutionary system."

In an effort to keep itself on the cutting edge of medical technology and provide another tool for surgeons to do their jobs more effectively, Salina Regional officials purchased the da Vinci system in October 2009 at an estimated cost of $2 million.

Currently there are six to eight da Vinci systems in Kansas, and Salina Regional has the only one in north-central Kansas, said Luanne Smith, director of surgical services at Salina Regional.

"It's really the future of surgery," she said. "It changes all our abdominal and laparoscopic surgeries."

To perform surgeries using the da Vinci, Graber sits at a computer console with a highly magnified, three-dimensional view of the surgical area. Through the manipulation of control bars beneath the view screen engineered to replicate the natural movement of the surgeon's hands, Graber can control several robotic arms over the surgery table to make minimally invasive incisions in the patient.

"The controls allow you to maneuver inside the body," he said. "The arms are extensions of my hands and follow whatever you wish them to do."

Although it is a robotic system, Graber said, there is no robot performing the surgery.

"I'm in control all the time," he said.

Graber said the precision of the da Vinci system creates less blood loss for the patient, less scarring, less chance of infection and a quicker recovery time.

"With a traditional hysterectomy, there's a four- to six-week recovery time," he said. "With this machine, recovery time is about two to four weeks. Some patients with desk jobs went back to work six days later."

Despite the system's cost, Graber believes it more than paid for itself during the past year.

"If a patient stays in the hospital for a shorter period of time, it recoups its expense," he said. "I would say 90 to 95 percent of patients go home the next day."

The da Vinci Surgical System was championed in Salina by Dr. Ryan Payne, a urologist who used the machine to perform prostate cancer surgeries in Milwaukee before moving to Salina in June 2009.

"We had talked about this system for several years before Dr. Payne came to town," Smith said. "He was instrumental in causing us to invest in this technology."

Payne said the da Vinci makes surgery easier by providing a highly magnified, three-dimensional view of the surgical area.

"It puts you right up to where you're working," he said. "You get unparalleled depth perception. It also gives you much more freedom and enhanced mobility because you can control more than two instruments at once."

The visualization provided by the machine gives the surgeon a nearly tactile sensation of the tissues being operated on, Payne said.

"With the visualization, you get used to how much tissue has tension," he said. "You get used to visual clues instead of tactile clues."

Best of all, Payne said, the da Vinci is not hard to master for experienced surgeons.

"It would take a long time to learn if you were doing a surgery you weren't used to," he said. "But if you've been through surgeries, the learning curve isn't that steep."

Graber said he learned the system by watching other surgeons use the machine and then by attending a daylong training session during which he operated the unit himself.

"After that, the da Vinci company brought someone in to watch me do surgeries," Graber said. "It wasn't hard to learn because when you start moving the instruments, they follow what you want them to do."

Other than Graber and Payne, Graber's partner at the Salina Women's Clinic, Dr. Merle "Boo" Hodges, has been trained on the system, as well as three obstetricians/gynecologists at Salina's Mowery Clinic, Smith said.

Smith envisions the machine being used to perform other types of surgeries in the not-so-distant future.

"We're working on getting a general surgeon trained so we can do more general surgeries," she said.

There may even be a time, she said, when a surgeon could sit at the da Vinci console and perform robotic surgery on a patient hundreds of miles away.

"With the right hook-up, you could even do this in space," she said.

nReporter Gary Demuth can be reached at 822-1405 or by e-mail at gdemuth@salina.com,