Robot aids surgeons, patients in everything from cancer treatment to weight loss | by Debra Melani

Posted on Thu, Jan 31, 2013

When Patty Fredericks stood amid the pack of runners lined up for the Rock ‘n’ Roll Half Marathon on the first day of fall this year, her fellow competitors pushing in around her on that brisk Denver morning had no idea what it took for her to get there. It was more than dealing with race traffic heading downtown from her suburban home in Littleton. It was more than rolling out of bed in the wee hours of a Saturday morning when most people were still sleeping. What brought Fredericks to the starting line that day was a life-altering journey.

Just nine months before, the 50-year-old mother of two lay on an operating table, becoming the first patient to undergo robot-assisted weight-loss surgery at Swedish Medical Center. At that time, after struggling with weight her entire life, she weighed more than 325 pounds and was unable to run a few feet, let alone 13.1 miles. Plagued by pre-diabetes, high cholesterol and high blood pressure, her days consisted of remembering to take a slew of pills and retaining enough energy after work to eke out some time with her 13-year-old son. But thanks to a birthday vow to herself, some intense willpower, and a truly minimally invasive bariatric surgery, Fredericks was on her way to her weight-loss goals almost as soon as she left the operating table.

Fredericks became HealthONE’s first bariatric patient to undergo da Vinci-assisted surgery with Dr. Richard Tillquist last December. When she finally sought out medical help for her weight issue, she knew, as a working mom, the procedure would have to be effective, efficient and complication-free. “I needed to heal quickly. I needed my surgeon to have the best possible tools to work with so he could do the best possible job and give me the best results,” Fredericks says. “So when he asked me if he could use the robot, I said: No problem.” Today, 140 pounds lighter and a proud finisher of a half marathon, Fredericks knows she made the right decision.

Since 2002, when HealthONE hospitals became the first in the Rocky Mountain Region to introduce the da Vinci® Robotic System into the operating room, thousands of patients have benefited from the most-advanced laparoscopic surgery available today. Although the four-armed surgical robot never fulfilled its original intent — providing remote battlefield surgery for the Army in the late 1980s — it has done everything from removing cancerous prostates and kidneys to repairing heart valves and prolapsed uteruses, all while putting patients back on their feet more quickly than traditional surgeries. HealthONE continues to lead the Denver area into the robotic era, with the recent debut in bariatric, as well as colorectal, surgeries.

“The visualization is better,” says Dr. Tillquist, who attached a gastric band around Fredericks’ upper stomach, creating a smaller pouch for food, which leads to a quicker sensation of fullness. “It’s easier to actually do the surgeries because of how the instruments work and because it’s like being inside the patient without having to manipulate tissue to reach the surgical area, which can be difficult with extremely obese patients,” Dr. Tillquist says. “I think, in the future, a lot of surgery will be migrating in this robotic direction.”

Although surgeons are still in control with da Vinci®, they sit at a console a few feet away from the patient, peering through a high-definition, 3-D, viewing system. Looking more like a teen playing a video game than a doctor performing surgery, the surgeon uses hand controls to manipulate the robotic arms, which are inserted strategically in the patient through small (less than half inch) incisions and mimic the surgeon’s motions, but on a much more minute scale. Superb range-of-motion, coupled with a magnified vision system that surgeons say gives the illusion of being inside the patient, can lead to excellent outcomes with less risk of blood loss, infections, scarring and other serious complications. For Fredericks, it meant being on the road to weight loss more quickly.

“I had my surgery and five days later I was in the desert celebrating my birthday in Palm Springs,” says Fredericks, who made the vow to get healthy on her 50th birthday, giving herself bariatric surgery as a gift. “I had to keep reminding myself that I had incisions in my stomach. I lay out at the pool. I drove. I shopped. I had no pain, no complications, nothing but success.” And thanks to what Dr. Tillquist calls Fredericks’ intense dedication to the plan, success came quickly. “With the gastric band, you have to be very strict with your diet and exercise program,” Dr. Tillquist says. “If you do that, you’ll be successful. If you don’t, you won’t. I saw that Fredericks was extremely motivated.”

In less than nine months, Fredericks went from a size 24 to a size 12. She continued setting goals and checking firsts off her “bucket list” to stay motivated, such as representing Swedish Medical Center in the Bolder Boulder 10K with her son and cruising Colorado’s high-country roads on a Harley Davidson. “I told the hospital I would run the Bolder Boulder for them, so I had to keep training.” Although she started out unable to even run a mile, Fredericks kept at it, using running (and crocheting) as substitutes for emotional eating.

Dr. Tillquist hopes the proliferation of da Vinci into bariatric surgery can help more of today’s growing obese population experience the life-changing weight-loss that Fredericks did. Recent research shows bariatric surgery leads to a marked reduction in pre-indicators of diabetes and heart disease, top killers today and both issues Fredericks was facing. “I was sick all the time. I carried around a baggie of pills.”

Her doctors took her off all her medications (expect a thyroid drug) since her refocus on health, a significant reward for both Fredericks and Dr. Tillquist. “Working with bariatric patients is great,” Dr. Tillquist says. “The weight loss completely changes their lives, and they are so appreciative. They are able to do things they couldn’t do before. If you had told Patty a year ago that she could run a half marathon, she probably never could have imagined it.”

But she did it. “I laughed. I screamed. I hollered. I pounced on the finish line,” Fredericks says of her half-marathon finish, witnessed by her daughter, 23, and her daughter’s boyfriend, who followed Fredericks along the way, taking photos and shouting encouragement. “It was the best feeling in the world,” Fredericks says. “It was a dream come true.” But Fredericks isn’t stopping with one dream. The day after finishing the half marathon, she was plotting her next adventure. “I’m going to start training for a triathlon,” says Fredericks, who encourages anyone struggling with fitness to set goals and stick with them. “It’s hard, especially if you are a mom, and there are just so many things you have to do. But it’s important to say: I have to count, too. This has just been an amazing journey.”

Tags: bariatric patient, da Vinci, DaVinci, Denver, Dr. Richard Tillquist, surgical robot, Swedish Medical Center, weight loss