Robot-assisted prostate cancer surgery is not new, but still some patients think of sci-fi automatons at work, said Dr. Stefanie Seixas-Mikelus. But the procedure is better typified as smart tools operated by competent clinicians.
Seixas-Mikelus is one of a handful of fellowship-trained, female urologists who apply robotic surgery techniques to operate inside the body.
“Instead of large incisions needed to allow a surgeon’s hands access to organs, a surgeon controls robotic-type hands in real time, precisely manipulating small scopes and instruments — without the possible hand tremors or fatigue that a surgeon can experience,” said Seixas-Mikelus, 36, who practices at Andover Urology in Massachusetts and at the Parkland Medical Center in Derry, N.H.
How do you feel being a woman in a largely male specialty?
More and more women are entering the urologic workforce. I got exposed to the field through my mom, who needed to see an urologist, and I tagged along with her. Then, early on in medical school, I shadowed a urologist and liked the fact that there’s a good balance between clinic-based medicine as well as spending time in the operating room. I give a lot of credit to the women who paved the path before me. In fact, at one point, a male surgeon even told me I should go into a practice more acceptable to females, such as pediatrics or psychiatry.
Is a surgeon using robotics operating in virtual reality?
Not virtual reality but 3-D; everything is at least 10 times magnified, so surgeons are able to see tissues better and possibly spare critical nerves. When a prostate gland is removed, for example, the prostate lies deep within the male pelvis. Neurovascular bundle and muscle fibers need to be preserved. With traditional surgery, visibility can be limited; the robot allows for better vision as well as more precision.
How can patients best find an experienced surgeon?
How has the Affordable Care Act affected you?
Of course it’s still in its early stages, and as physicians we still don’t know what to expect. There’s definitely some apprehension; we are obviously concerned about reimbursement, especially for some of the more complex surgeries. The costs of maintaining an office are going up, while reimbursements are going down.
Do you like wearing scrubs?
Believe it or not, I think they’re one of the most comfortable clothing you can wear. They’re very light and loose and feel like jogging pants.
You grew up as part of the Nintendo generation — does that give you an advantage in using these robotic systems?
Studies have shown that physicians who use the robot well early on are also adept at video games.
I even asked some other skilled robotic surgeons if they played video games when they were kids, and the majority did. It helps with hand-eye coordination, so I guess it makes sense.
So when your kids are playing video games, remember there might be some benefit down the road.
Cindy Atoji Keene can be reached at atojic@gmail.com.