This report originally appeared in the June 2010 issue of DOTmed Business News

If there are two things that Dr. Ash Tewari loves, they're cricket and robotic surgery. The walls of his cozy office, tucked away on the ninth floor of the New York Presbyterian Hospital/Weill Cornell Medical Center, are covered with cricket memorabilia, including a framed poster that explains the sport to strangers of the game. It shares the space with glossy magazine covers about robotic surgery and the top surgeons who perform the procedure.

It's just before 3 p.m. on a windy spring day and Dr. Tewari has already completed four robotic prostatectomies. He is the professor of urology and outcomes at the Weill Cornell Medical Center and the director of the Lefrak Institute of Robotic Surgery at New York Presbyterian Hospital.
"I got involved with robotic surgery about 10 years ago," says Dr. Tewari. "Since then, robotic procedures have become quite popular."

Years ago, patients would have to demand the surgery be done using the technique, but today, it is the golden standard used for the removal of prostate cancer cell masses.

"Last year, just for prostate cancer, out of about 70,000 prostatectomies being done in the U.S. 70 to 80 percent of them were done using a robot," says Dr. Tewari.

Surgeons cite a number of advantages to robotic surgery, such as minimal blood loss, less discomfort, faster recovery time and higher likelihood of urinary and sexual functions returning to normal. The surgeons also physically benefit from the procedure, experiencing less physical strain because they are sitting at the console while operating the robot. This allows them to perform more surgeries in a day and have better vision of the organs they are operating on.

"The surgical platform is quite immersive," says Dr. Tewari. "You can actually see things in three dimensions. The third dimension makes you feel as if you are inside the patient's body, very close to the organ you are working on and you are a part of that process."

Wearing 3-D glasses and watching the procedure on a big screen in Dr. Tewari's office is like having a front row seat to the prostatectomy (hold the popcorn). While the robotic arms work swiftly and delicately, it is easy to forget that the surgeon is controlling the instruments that are cutting and cauterizing the tissue from just a few feet away.

A shift in tradition
If anyone is a robotic prostatectomy expert, it's Dr. Vipul Patel, the director of urologic oncology and medical director of the Global Robotics Institute at Florida Hospital. He has performed more than 3,500 robotic procedures to date, more than anyone else in the world.

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