Keesler Air Force Base surgeons are forging a new path in military medicine by being the first in the Air Force to use one of the most advanced robotic surgery systems available today. The Keesler Medical Center has acquired two of the newest robotic surgical systems out there, the da Vinci Xi, one for surgeries and the other for surgical training. Also, Keesler’s Clinical Research Laboratory has set up a training facility called the Institute for Defense Robotic Surgical Education, for surgeons to get their official robotic surgery credentials.
“Robotics is the standard of care for several surgical procedures, and the market in the private sector is exploding,” said Maj. (Dr.) Joshua Tyler, the 81st Surgical Operations Squadron robotic surgery director. “If you’re not doing robotics, you’re not going to be competitive. The reason for that is better outcomes.”
It’s the patient who experiences most of the outcomes of surgery, said Tyler, and when it comes to robotic surgery there can be a lot of positive benefits.
“Smaller incisions, lower risk of hernia, and a lower risk of infection means getting out of the hospital sooner. Each additional day in the hospital is $1600,” Tyler said. “If we’re having better outcomes and eliminating some of these things, we’re saving money and doing better by our patients.”
Tyler said a good example of this is hernia surgery, which can leave patients in pain. With robotic surgery, the post-operative pain is much lower for patients and that means faster recovery.
Robotic surgeries require systems that are quite expensive and require surgeons to undergo a whole new kind of training. Until recently, any time an Air Force surgeon wanted to perform a robotic surgery they had to use a system in place at a private hospital as part of an External Resource Sharing Agreement and had to get trained on the system through a course that required them to be away from their clinic.
To address this problem InDoRSE has set up a training facility on base for surgeons to earn their official robotic surgery credentials. InDoRSE’s focus has always been on training, graduate medical education, and research and development. For Lt. Col. (Dr.) Thomas Shaak, the 81st Medical Support Squadron’s director of InDoRSE, creating a program for robotic surgery falls in line with their mission.
“With this research robot, our residents will graduate with fully recognized robot credentials,” Shaak said. “Our surgeons should already be trained in surgeries, and with this credential, we’re giving them another tool in their toolkit to properly select good candidates for robotic procedures.”
Shaak said the manufacturers of the da Vinci Xi surgical systems, and the usual providers of robotic credentials, have agreed to a unique partnership where they will recognize the training coming from the InDoRSE training site.
He said because InDoRSE already has training space setup, everything can be done right on site. They can even have people come from remote locations and stay at the housing near the medical center. The whole system is in place for surgeons to get their robotic credentials.
“This is pushing technology and innovation for the next generation of surgeons and surgical technology,” Shaak said. “We’re bringing that to our patients in the name of better outcomes. The better the outcomes, the better it is for the patients and the more money is saved.”
The vision for the training facility extends to not just the Air Force but the Department of Defense as a whole. This includes more than just surgeons. Since nurses and technicians need robotic surgery training as well for their respective roles, Shaak and his team want to train anyone who benefits from it.
“What we’re doing here is unique,” Tyler said. “When you look at Air Force surgeons at other major medical centers, none of them have robots but they’re still doing robotics. This meets a need not just for Air Force surgery, but it can also serve as a model for other DoD medical centers as they venture into robotics.”