By Bari Faye Dean
Dr. Benjamin Sadowitz
When Crouse Health acquired its first da Vinci surgical robot in 2008, it marked the beginning of a journey that would reshape surgical care across Central New York.
Two years before the first robotic case was even performed at Crouse,
administrative leadership made growing the hospital’s robotic surgery program a strategic priority. Now, with 40 surgeons who specialize in robotics, Crouse has built a collaborative, multidisciplinary program. The hospital’s commitment has resulted in the largest, most advanced robotic surgery program in the region.
The program has an unmatched record, grounded in teamwork and experience. The program began with a single da Vinci robot and the ambitious goal of reaching 300 robotic surgeries a year within three years. That benchmark was quickly exceeded.
Today, the program is home to 11 robots, including nine da Vinci Surgical Systems used in gynecology, urology, colorectal, cardiothoracic, bariatrics and general surgery.
The da Vinci platform has “arms” that provide surgeons with greater dexterity and range of motion as compared to traditional surgical instruments. Further, the da Vinci’s high-definition 3D vision system provides surgeons with a clear, magnified view of the surgical area.
Crouse also has two Mako robotic guidance systems which use an “arm” as well as advanced imaging to guide orthopedic surgeons during procedures like spinal surgeries and joint replacements. Again, these robots allow for minimally invasive surgeries and, especially important in orthopedics, ensure the precise placement of implants.
Crouse surgeons affiliated with the da Vinci program perform an average of 2,500 robotic surgeries annually and over 20,000 da Vinci cases have been completed at Crouse to date.
For physicians, the program offers more access to robotic equipment, shorter case times and the ability to work with seasoned professionals across disciplines. Additionally, the hospital has an Advanced Robotics Steering Committee that gives physicians a seat at the leadership table when it comes to making decisions about growing the program and staying on top of the latest technology.
The Power of Volume and Experience
Having more robots, very simply, means Crouse completes more robotic surgeries than other healthcare organizations in the region, said general surgeon Ben Sadowitz, MD.
And volume directly correlates with improved outcomes. “High-volume programs consistently have better outcomes,” added Dr. Sadowitz. “That’s not just about the surgeon’s skill, but the collective experience of the entire operating team.”
The importance of a seasoned team cannot be overstated. From physician assistants
and anesthesiologists to scrub techs and OR nurses, everyone involved in the robotic surgery process at Crouse is highly trained and invested in delivering outstanding care. Mary J. Cunningham, MD, who specializes in complex gynecologic oncology cases, including surgeries for ovarian and endometrial cancers, has seen the benefits of this across-the board experience first-hand. She performed the first robotic surgery at Crouse in 2008.
“The whole team must be committed and able to develop their expertise. This affects everything from reducing operating times to lowering the risk of complications to improving outcomes.”
Crouse’s high performance doesn’t stop when the surgery is completed. The hospital has built a comprehensive postoperative care model that supports minimally invasive surgery patients from start to finish, explains David Nesbitt, MD, a colorectal surgeon who has been performing robotic surgeries at Crouse for 16 years. He opened his Syracuse-based colorectal medical practice 21 years ago.
“There’s a very specific protocol on how patients are supposed to progress after robotic surgery,” he said. “We even have a dedicated floor for these patients, and the nurses know the care plan inside and out. That makes a big difference in patient satisfaction and outcomes.”
And that team commitment runs deep. From physician assistants and anesthesiologists to scrub techs and nurses, Crouse has cultivated a culture where every team member plays a key role. This team based culture has made Crouse a destination for visiting surgeons from across the country, who come to observe a program where every member of the surgical team plays an integral role.
Patient Benefits: Smaller Incisions, Faster Recovery
For patients, Crouse’s leadership in robotics means access to minimally invasive surgery, which results in shorter recovery times and improved outcomes.
“Patients who opt for robotic surgery typically experience less pain and a reduced need for narcotics pain relief. This means patients who choose Crouse are able to return to their lives faster,” explains Dr. Nesbitt, who has performed 2,000 robotic cases at Crouse. “The difference in recovery is night and day,” he said. “Patients used to stay in the hospital seven to nine days after a colon resection. Now they go home far more quickly.”
Only One Incision Needed
Robotic surgery has transformed patient care across all the specialties at Crouse. Procedures that once required large incisions and lengthy hospital stays are now performed through small incisions.
Board-certified urologist Po Lam, MD, is able to do robotic surgery with a single two-centimeter incision. He specializes in treating patients with prostate cancer, kidney cancer, bladder cancer and difficult kidney stones with the da Vinci SP – a single port robot. Crouse is the only hospital in the region with a da Vinci SP.
During his more than two decade career, Dr. Lam has performed over 3,000 robotic surgeries in Central New York. Since Crouse obtained the da Vinci SP, he has performed more than 500 urologic surgeries on Crouse patients.
Single port robotic surgery is an emerging field in urology. “In fact, single port robotics is the future of surgery. It will advance and truly change the way surgery is performed across all specialties,” he said.
There are several reasons why Dr. Lam is focused on using the da Vinci SP. It allows for a smaller incision and quicker recovery for the patient. “Single port surgery allows me to focus on the very specific small area I need to access and it allows me to access areas that I cannot reach with the multi port robot,” he said.
This is because the da Vinci SP has a flexible camera and instruments. “I can see around corners and there is minimal interaction with major abdominal organs. There’s no question about it,” Dr. Lam said, “using the da Vinci SP results in far fewer complications for the patient.”
Dr. Lam also commented that he has chosen to keep his practice at Crouse because of the outstanding support the robotics program gets from senior leadership.
At Crouse, Commitment to Robotics Starts at the Top
Indeed, unwavering support from hospital leadership is one of the most important contributors to the success of Crouse’s robotics program. Crouse’s administration has not only invested in robotic technology but has made it a strategic priority.
“They’ve worked with us to grow the program from the beginning,” said Dr. Sadowitz. “We’ve carved out a niche as a robotics institute, and that comes from long-term support at every level.”
CEO Kronenberg joined Crouse’s medical staff 25 years ago. He has watched the organization grow from the days when robotics was new technology to today when it’s the standard of care and is proud to say Crouse was an early adopter of robotics technology. He and senior leadership at the hospital fully believe in growing the program’s multidisciplinary approach and ensuring surgeons have access to the best tools and ongoing training.
Staying on the Cutting Edge
At Crouse, that growth includes investments in the latest technology. The transition from the da Vinci Xi to the newer DV5 system has brought improvements not only in surgical capabilities but also in surgeon ergonomics.
“Standard laparoscopic surgery can be hard on a surgeon’s neck and back,” said Dr. Nesbitt. “Each new version of the robot allows us to operate more comfortably, which translates into better focus and performance in the OR.”
While robotic platforms offer unmatched precision, it’s the surgeon and team who make the real difference. The equipment may change over time, as will technique. But success in robotics will always be connected to the interaction between people in the hospital and their commitment to success.
A Destination for Referrals
For physicians referring patients to Crouse, the message is clear: they are in good hands. When you send a patient to Crouse, you can be confident they’ll be cared for by a team that’s done this thousands of times.
Dr. Sadowitz, who has observed robotic programs at other institutions, believes Crouse offers a rare combination of access and experience. “At many hospitals, it can be hard for a surgeon to get access to a robot. Here, we have the equipment, the volume and the teams to make it all work seamlessly.”
For more information about the Crouse Institute for Robotics, please visit: https://www.crouse.org/services/robotic-surgery/
