From 1 to 1,000: How Robotic Technology Has Brought Surgeons Together at Nationwide Children’s Hospital

From 1 to 1,000: How Robotic Technology Has Brought Surgeons Together at Nationwide Children’s Hospital 1024 683 Marc Michalsky, MD, MBA, Karen Diefenbach, MD, Molly Fuchs, MD and Daniel DaJusta, MD

This month marks an important milestone for patients receiving care at Nationwide Children’s Hospital in Columbus, Ohio: the completion of our 1,000th minimally invasive case using the DaVinci Robotic System. Nationwide Children’s was one of the first large children’s hospitals in the country to acquire a robotic system (2013) and like many, the decision was made in support of our nationally renowned Division of Pediatric Urology. Under the guidance of Rama Jayanthi, MD, chief of Pediatric Urology, the installation of the DaVinci system set the stage to offer patients the opportunity to undergo complex urinary tract reconstruction procedures using a minimally invasive approach enhanced by high-fidelity, three-dimensional imaging and improved surgical ergonomics.

Today, the program is one of a handful in the nation performing complex bladder reconstruction surgeries including bladder neck reconstruction for incontinence, bladder augmentation and Mitrofanoff channel for intermittent bladder catheterization. Thus, being one of the leading programs in expanding the uses of the robot in the field of pediatric urology.

While general and thoracic pediatric surgery has been slower to adopt robotic technology, the pediatric surgery division, under the guidance of Gail Besner, MD, chief of Pediatric Surgery, and Karen Diefenbach, MD, director of Minimally Invasive Surgery, was quick to recognize an opportunity to advance minimally invasive surgery for the pediatric population. Nationwide Children’s is one of the busiest general and thoracic pediatric surgery robotic centers in the United States, the team performs a variety of cases including, metabolic and bariatric surgery, cholecystectomy, splenectomy, hiatal hernia repair, fundoplication, median arcuate ligament (MALs) release as well as chest wall and mediastinal mass resections.

Since the program’s inception, the robot has also served as a common platform to bring surgeons from different disciplines together in the operating room. As an example, a typical case at Nationwide may include input from robotically trained members from pediatric urology, general and thoracic surgery as well as the advanced colorectal teams. It is this level of multidisciplinary collaboration and collegiality that allows important exchanges of ideas and experiences; no doubt leading to better outcomes for our patients.

In 2020, Nationwide Children’s upgraded our robotic system to the DaVinci Xi which has led to an enhanced ability to perform more complex cases and expand our culture of collaboration. As our team of robotic surgeons continues to embrace such advanced technology, we look forward to continuing to share our experiences while seeking to gain additional insights from others.

As we approach the 1,000th robotically assisted operation, it seems appropriate to reflect on how far we have come; from an eager curiosity to explore the possibilities of applying new technology in the pediatric space, to a culture of collaboration and determination that has helped to distinguish Nationwide Children’s as a leader in this evolving treatment area.

In addition to the institution’s renewed commitment to robotic technology with the acquisition of the DaVinci Xi, the robotics team is also excited to help christen the newly opened Education Building and Simulation Center with the installation of the now clinically retired DaVinci Si system (acquired in 2013). Having a fully functional robotic system in the Simulation Center offers numerous educational opportunities for our surgical trainees, surgical faculty and our surgical colleagues through planned professional outreach.

About the author

Marc P. Michalsky, MD, MBA, is professor of Clinical Surgery and Pediatrics at The Ohio State University College of Medicine and serves as vice chair of Strategic Operations for the Department of Pediatric Surgery, director of the Center for Robotic Surgery, and surgical director for the Center for Healthy Weight and Nutrition at Nationwide Children's Hospital.

Karen A. Diefenbach, MD, is the director for Minimally Invasive Surgery at Nationwide Children's Hospital, and associate professor in the Division of Pediatric Surgery at The Ohio State University College of Medicine.

Molly E. Fuchs, MD, is an attending urologist at Nationwide Children's Hospital.

Daniel G. DaJusta, MD, is a surgeon in the Section of Urology and the Director of Urologic Surgery for the Center for Colorectal and Pelvic Reconstruction at Nationwide Children's Hospital.