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Dr. Hashemi Amazed by Robotic Surgery

Urogynecologic Surgeon Says Robotic System Is More Precise Than Laparascopic Procedures

When Newark Beth Israel Medical Center surgeon Emad Hashemi learned how to perform minimally invasive surgery, the laparoscope was the instrument of choice.

Then robotic surgery came along. And Hashemi, who is chief of Urogynecology and Pelvic Reconstructive Surgery at Newark Beth Israel Medical Center, learned how to perform familiar procedures with different instruments.

He was amazed at what he saw.

“Robotic surgery is just more precise, much more absolute,” Dr. Hashemi says. “You have much more control with robotic surgery.”

Dr. Hashemi used the da Vinci® S robotic system in surgery for the first time in December 2006. He used it to perform a sacral colpopexy, which is considered the gold standard for repairing vaginal vault prolapse.

He has performed a handful of sacral colpopexies robotically since then, making him one of the few doctors in the country to perform this delicate surgery robotically.

In addition, Dr. Hashemi has used robotics to perform uterosacral ligament fixation procedures, which is another way of repairing vaginal vault prolapse; as well as standard hysterectomies.

The Food and Drug Administration granted clearance for use of the da Vinci® Surgical System for use in gynecological procedures in April 2005, opening the door for Dr. Hashemi to use the new technologies in surgery.

More surgeons may follow suit, particularly when you consider that approximately one in nine women in the United States will have a hysterectomy in their lifetime, and, of those, 10 percent to 30 percent will develop vaginal vault prolapse, according to mayoclinic.com.

Meanwhile, vaginal vault prolapse is yet another robotic surgery performed at Newark Beth Israel, where surgeons currently perform robotic surgery in more specialties than any other facility in the nation. The hospital is a member of Barnabas Health.

Additionally, Dr. Hashemi was able to be an early adapter on using the new technology because Newark Beth Israel is home to a recently-opened Robotic Training Center, where surgeons from around the world learn advanced robotic surgery techniques using the da Vinci® S Surgical System.

The Robotic Training Center has trained more than 100 surgeons on the da Vinci ® S since opening last year. The doctors have come to Newark Beth Israel from throughout the country, including from hospitals such as Yale-New Haven Hospital, Evanston Northwestern Healthcare, Massachusetts General Hospital and the Mayo Clinic.

Dr. Hashemi believes that performing robotic surgery feels like writing with a pencil the conventional way. By comparison, the laparoscopic version offers less control to the surgeon – a lot like trying to write with pencil by gripping the eraser end.

“I have much more control of the instruments (with robotics) in 360 degree rotation and ‘XYZ’ directional movement to make tissue dissection and suturing with more precision,” says Hashemi. “I make small incisions, which means there is less risk of distortion of normal anatomy, less bleeding, infection and pain.”

A native of Iran who holds a medical degree from Saint George's University School of Medicine in Grenada, West Indies, Dr. Hashemi completed his residency in OB/GYN at Newark Beth Israel, where he served as Chief Resident of OB/GYN. Following that, he did a fellowship in urogynecology at Athena Women’s Medical Center, a teaching affiliate of the University of Medicine and Dentistry of NJ (UMDNJ), in Turnersville, N.J. before returning to Newark Beth Israel to become chief of Urogynecology and Pelvic Reconstructive Surgery.

Dr. Hashemi also says robotic surgery provides him with a three-dimensional visual field of the region that he is operating on. With robotic surgery, the surgeon sits at the console with his hands on the master controls and his eyes on a 3-D image of the surgical field.

From the patient-side cart, four robotic arms and one endoscope arm precisely translate the surgeon’s movements through small incisions in the patient.

In the future, Dr. Hashemi believes that more and more surgeons will follow suit and using robotics where they now use the laparoscope.

“As time goes on, a larger number of surgeons will become comfortable with this machinery and turn to robotics,” he says. “We will see how far we can go with robotics.”

Publication: Hospital Newspaper

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