Murdoch home to first WA surgeon using da Vinci robot for upper GI and bariatric surgery

18 Dec 2019

18 December 2019 

Specialist Upper GI Surgeon Mr Krishna Epari was recently accredited for use of the da Vinci Xi Surgical System.

For a person who loves technology, he has been able to combine his career and hobbies into one, with Mr Epari saying he enjoyed operating with the robot to deliver great patient outcomes.

“I have always loved staying at the forefront of technology. The ability to apply that to my surgery and enhance the outcomes is very exciting,” he said.

“While other disciplines of surgery around Australia have been using earlier versions of this robot for many years, the latest fourth generation brings many advantages and is more applicable in my field.

“This is the biggest technological change we have had for many years and I have been looking forward to this for a while.”

Mr Epari said use of the da Vinci robot would provide greater precision and control than traditional minimally invasive keyhole surgery and was particularly useful for performing complex tasks in confined spaces.

“In complex operations where you are suturing the stomach and bowel, the da Vinci provides more precision and control,” he said.

“Rather than being straight like conventional instruments, robotic tools have internal wrist joints which can move more naturally like the human hand.

“The robot makes complex tasks easier for a skilled surgeon to perform with increased dexterity and greater precision whilst reducing tremor and fatigue. The literature suggests there are decreased patient complications including leakage and bleeding.”

Positive reaction

Mr Epari said there had already been a positive response from patients to undergo robotic-assisted surgery.

He has already performed Roux-en-Y gastric bypass, single anastomosis gastric bypass, loop duodenal switch (SIPS/SADI-S), sleeve gastrectomy, hiatus hernia repair and radical total gastrectomy for stomach cancer.

“The da Vinci Xi has an intelligent stapler which is able to constantly sense tissue thickness, and deliver more uniform stapling,” Mr Epari said.

“To be clear, the robot is not fully automated and is under control of the surgeon at all times. There’s been an amazing level of interest and it is exciting to be able to offer the latest technology to my patients.”

In addition, use of the robot is proving ergonomically beneficial for surgeons, which allows them to maintain their focus on the patient’s operation.

“With traditional surgery you are restricted to standing by the side of the operating table, which constrains movements and might mean being in awkward positions for prolonged periods which can lead to fatigue and musculoskeletal issues,” Mr Epari said.

Robotics at Murdoch

St John of God Murdoch Hospital Chief Executive Officer Ben Edwards said the da Vinci robot was recently installed in Murdoch’s theatres.

"We are incredibly proud to be at the forefront of robotic technology in WA and provide great patient outcomes,” he said.

“In addition to the use of the da Vinci Xi system across a range of specialties including urology and bariatric surgery, Murdoch also offers robotic-assisted surgery in orthopaedics through the MAKO and NAVIO robots.”