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Mount Sinai Builds on its Robotic Surgery Techniques with New Institute

November 16, 2016
by Rajiv Leventhal
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Mount Sinai Health System in New York City has established a robotics institute aiming to advance patient care and augment research and training.

The Mount Sinai Robotics Institute (MSRI), established at the Icahn School of Medicine at Mount Sinai, will have the goal of optimizing robotic technology and multidisciplinary care, the health system said in a recent press release. For years, surgeons at Mount Sinai have employed robotic surgery as a treatment for a variety of conditions including urological disease, oral and throat cancers, obstetrical conditions, cardiovascular disease and neurological conditions. 

In one example, for robotic surgery in head and neck patients, Mount Sinai sends frozen sections of tumors at the time of surgery to pathology, which conducts a rapid turnaround of results while the patient is still asleep.  If the cells are positive, the surgeon resects more to ensure margin accuracy.  Additionally, the Head and Neck Cancer Research Program has a history of evaluating and utilizing new optical technologies for increased margin control and more precise tumor identification, officials pointed out.

To this end, Eric M. Genden, M.D., Dr. Isidore Friesner Professor and Chair of the Department of Otolaryngology—Head and Neck Surgery at Mount Sinai and co-chair of the Institute performed the first transoral robotic surgery (TORS) in New York in 2008. He said, “We were an early adopter of the da Vinci Surgical System and we have been studying robotic oropharyngeal cancer treatment since then.  We have found robotic surgery—for a variety of disease conditions—minimizes our patients’ recovery time and maximizes their outcomes.”  Since then, Dr. Genden and his team have enhanced the TORS technology for removing tumors in the throat, tonsils, and base of the tongue to improve patients’ recovery, cosmetic appearance, and ability to speak and swallow.

“In the past, these tumors presented a significant challenge to reach, and traditionally were removed by surgeons through a large incision stemming from the top of the lip to the throat.  However, the advent of robotic technology brought about a momentous paradigm shift in the removal of tumors and the benefits it delivers to patients,” said Genden.  “Our studies have shown that minimally invasive robotic surgery has resulted in fewer days in the hospitals and fewer complications for patients.”

Another instance involves Ash Tewari, the Kyung Hyun Kim Chair of the Milton and Carroll Petrie Department of Urology at Mount Sinai, co-chair of the Institute. Tewari developed the robotic prostate surgery technique called Advanced Robotic Technique prostatectomy, or ART. According to officials, it is a highly individualized technique that reflects a patient’s unique anatomy, cancer location, and neural structure while removing cancer and minimizing side effects in select patients.  Through ART, Dr. Tewari delicately removes the prostate while preserving sexual and urinary function.  

In treating patients, Tewari and his team use a combination of precision medicine approaches including advanced imaging, genomics, and translational research.  In addition, Mount Sinai has pioneered the use of NeuroSAFE, an advanced procedure that lets the surgeon know if all the cancer has been excised during the operation itself.  It is the only institution in the United States currently using this technology, officials noted. “The robotic urological cancer surgery program reflects almost two decades of experience and research into mastering and refining the robotic technique in order to ensure we achieve the highest levels of cancer control for patients while preserving nerves responsible for erectile function and continence,” said. Tewari.

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