Robotic Revolution

Da Vinci surgical system can help reduce patient trauma, recovery time.

Jenny Rodriguez

When she moved from Puerto Rico to Florida 17 years ago, Jenny Rodriguez didn’t speak a word of English. Now, she speaks the language so well that she’s part of a team that helps non-English speakers learn English and adjust to life in the states.

“I work for the School District of Manatee County; I’m a secretary for the director of the ESOL program,” Jenny explains. “ESOL stands for English for Speakers of Other Languages. We help students and people from other countries succeed.”

Jenny, 41, began her journey to success 14 years ago, while pregnant with the second of three children. She was also carrying dozens of unwanted pounds, a burden that grew as years passed.

“I’ve struggled with my weight most of my life, but the last 14 years were the worst, by far,” Jenny confides. “I eventually became so overweight that a couple years ago I started to have trouble walking because the weight caused so much foot pain.

“There was one day where I went to Universal Studios with my kids, but after a while, I had to tell them, You just go ahead without me because I can’t do it anymore.

Jenny recalls resting nearly two hours until the pain subsided before catching up with her family in the Orlando theme park.

“But that wasn’t my only problem. I had other serious health problems, like sleep apnea, prediabetes and high blood pressure. It was awful. I wasn’t even 40 years old, and I felt like I was dying,” she laments.

“But it wasn’t just physical pain. There was emotional pain, too. There were days when I would go shopping for clothes and I would sit in the fitting room and cry because nothing looked good on me. I didn’t feel pretty or confident. I just felt awful.”

Jenny insists she tried everything she could think of to lose weight.

“If someone suggested a diet to me, I was like, Yeah, I know that diet. I tried it. It didn’t work. Nothing worked for me,” Jenny says. “That’s why I finally went to see Dr. Rekkas.”

Bariatric surgeon Stelios Rekkas, MD, FACS, FASMBS, of Manatee Weight Loss Center/ Manatee Physician Alliance, is medical director of the bariatric program at Manatee Memorial Hospital. All facilities are members of the Manatee Healthcare System.

Jenny learned of Dr. Rekkas through a friend who had undergone a vertical sleeve gastrectomy at Manatee Memorial Hospital, where Dr. Rekkas performs the surgery using a sophisticated tool called the da Vinci® Robotic Surgical System.

da Vinci® Robotic Surgical System

 

“An Incredible System”

This system allows surgeons to complete a variety of minimally invasive procedures while sitting at a remote console, where they view a magnified 3D image of the work area and control the da Vinci system’s robotic arms with toggle sticks.

“It’s an incredible system, and when I tell a patient I’m going to be using it, they inevitably ask me, Well, who’s doing the surgery, you or the robot?” Dr. Rekkas relates.

“I can assure you, the surgeon is doing the surgery. The surgeon is in complete control of the robot. The robot does not make any decisions, and it does not do any cutting. All the robot does is assist and augment what the surgeon does. But everything the surgeon does is done remotely.”

The surgeon works in the same room as the patient. Instead of standing over the patient, however, the surgeon sits comfortably at a table and controls the camera and robotic arms, which perform the surgical motions normally done by the doctor.

Surgeries using the da Vinci system are typically completed in less time than traditional surgeries and considered far safer for the patient because the robotic arms are more stable than any surgeon’s hands.

In addition, the work is performed through three 8 mm-long incisions, not a long, deep opening. This results in better outcomes and shorter recovery periods. In many cases, surgeries that traditionally required weeklong postop hospital stays require one or two days.

“The hospital has done a great job of providing us with the tools we need to do our best work,” – Dr. Rekkas

Dr. Rekkas performs these surgeries at Manatee Memorial Hospital, which he lauds for its investment in robotic platforms.

“The hospital has done a great job of providing us with the tools we need to do our best work,” he states. “It has taken the initiative to be an advanced minimally invasive surgical center, and it provides excellent nursing care.

“In addition, it provides a bariatric coordinator for all patients that we work hand in hand with. As a result, most patients stay only one day in the hospital, and with the coordinator’s help, we make an impact and a difference in our patients’ lives.”

Surgeons must be trained in the use of the system to operate it.

Dr. Rekkas, for example, is certified as a Surgeon of Excellence in Robotics by Surgical Review Corp. And while he specializes in bariatric surgery, other procedures can be performed using the da Vinci system.

“There are a lot of applications that this system can be used for,” says Stacey South, MD, chief of staff at Manatee Memorial, where she has completed more than 1,500 surgeries using the da Vinci system.

“It can be used to remove endometrial cancers, pelvic masses, abnormal bleeding as well as many other surgeries. We can even use it with some ovarian cancers. It’s something that is becoming more and more common in hospitals these days.

“It offers the surgeon the opportunity to take a minimally invasive approach to surgery. That allows patients to get back on their feet more quickly because there’s less trauma, less pain, less blood loss and less risk of infection.”

Down More Than 120 Pounds

In treating Jenny, Dr. Rekkas used the da Vinci system to accomplish two surgeries. In addition to the vertical sleeve gastrectomy, in which 60 to 80 percent of the patient’s stomach is removed, he also performed a hernia repair.

“Everything is done through little incisions, one of which is about an inch long, while the rest are less than half an inch in length,” Dr. Rekkas states. “The size of those incisions is one of the reasons people have less pain and recover so quickly.”

For years, the vertical sleeve gastrectomy was done through an incision about a foot long, and the surgeon had to stand over the patient and manipulate his instruments.

“It was hard to see sometimes, and it was a very stressful procedure,” Dr. Rekkas explains. “But now, once those incisions are made, a camera goes inside one of them that allows me to see everything inside clearly and in a three-dimensional environment. Next, a retractor elevates the liver, which allows me to go in and free up the stomach.

“Then a special robotic stapler actually clamps the stomach, seals it and cuts it. Finally, the part of the stomach that has to be taken out gets removed from the body through another small incision in the abdomen.”

When she first met Dr. Rekkas, Jenny weighed 260 pounds. Since the surgery in December 2019, Jenny has lost more than 120 pounds and regained the confidence and self-esteem lost through her weight gain.

“I would still like to lose another 8 pounds just to be on the safe side, but I’m doing great and feel so much better about myself,” Jenny raves. “I feel better wearing my clothes, and I look better.”
Most importantly, Jenny says she now has a lot of energy.

“I can do a lot of things that I wasn’t able to do before, like hiking. I’ve taken up hiking, which I love. It’s something I was never able to do before or really had any interest in doing. But now, I’m doing a lot of things I never used to do.”

I urge anyone who has a weight-loss problem like me to see him. The surgery he did for me at Manatee Memorial Hospital has been absolutely life-changing.” – Jenny

Jenny isn’t done with her self-improvement. She still wants to tone her body.

“So, I’ll look even better,” she expounds. “I’m not going to say, Well, I had the surgery, and everything is good. If you want to look good after the surgery, you have to work at it, and I’m working at it.”

Jenny calls the procedure “a breeze” and the recovery “much easier than I thought it would be.” It took her about two weeks to get back to normal.

“I was thinking I’d be down for a couple of weeks because I had two surgeries, the vertical sleeve gastrectomy and hernia repair, but I was out of bed and walking again after three days,” she recollects.

“Dr. Rekkas is a great doctor and I urge anyone who has a weight-loss problem like me to see him. The surgery he did for me at Manatee Memorial Hospital has been absolutely life-changing.”

© FHCN article by Roy Cummings. Jenny’s photo courtesy of Jenny Rodriguez. Before and after images courtesy of Manatee Weight Loss Center / Manatee Physician Alliance. mkb
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    • Manatee Memorial Hospital

      When it comes to choosing a hospital, one thing is clear: quality counts. Manatee Memorial Hospital has a long tradition of providing medical care in a comfortable and convenient environment each year for thousands of patients... Read More

    • Stelios Rekkas, MD, FACS, FASMBS

      Stelios Rekkas, MD, FACS, FASMBS, a graduate of Manatee High School, earned his undergraduate degree at the University of Florida and received his medical degree from Florida State University College of Medicine. He completed a general sur... Read More

    • Stacey South, MD

      Stacey South, MD, is chief of staff at Manatee Memorial Hospital and a graduate of Loyola University, Chicago Stritch School of Medicine. She completed a residency in obstetrics and gynecology at The Western Pennsylvania Hospital, Temple Un... Read More