Cutting-edge precision and control get robotic surgery patients back to life faster

Anxious and ready to be rid of the growth, Allaire chose surgery. And she was able to have it done with robot-assisted surgery, a minimally invasive approach with smaller incisions and shorter recovery times than with traditional “open” surgery. 

Five months later, Allaire again turned to robotic surgery, this time to treat an ovarian cyst and endometriosis.  

“For people who are considering robotic surgery and have a choice, I would say that my experiences have been overwhelmingly positive,” Allaire says. “It’s all gone so well because the doctors are experts in their trade.” 

Allaire’s procedures were at Community Hospital of the Monterey Peninsula, which started its robot-assisted surgery program in 2019, focusing first on gynecology and urology. Due to successful outcomes, increasing demand, and the addition of surgeons with expertise in other areas, the hospital has expanded the types of procedures offered and purchased a second robotic system in 2023.   

“We’re now the largest program on the Central Coast,” says Dr. Harsha Mittakanti, a urologist with Montage Medical Group and Medical Director of the program. “We started with three robotic surgeons, and now we have eight. I see that growth continuing, with patients coming to Community Hospital for the level of care they can get here rather than going to the Bay Area.” 

For those unfamiliar with robotic surgery, erase any images of an independently operating android. In reality, a human surgeon is in control. 

Working from a console about 10 feet from the patient, the surgeon precisely guides the four arms of a robotic device that is at the bedside. One of the robotic arms holds a state-of-the-art camera, providing high-definition, 3D images of the surgical area. The other arms have tiny surgical instruments. Each is inserted into the body through a small incision. The tools exactly mimic the hand and wrist movements of the surgeon in real time, as if their own hands are inside the body. 

“In the right hands for the right case, robotic surgery is a pretty phenomenal tool,” Mittakanti says. “But it’s not the right surgery for everything. Patients need to discuss with their surgeons what the most appropriate tool is for their case.” 

Robotic surgery was the right tool for removing the tumor embedded deep in Allaire’s kidney. Mittakanti’s goal was to remove the entire tumor while sparing as much healthy tissue as possible. 

First, he clamped off blood flow to the affected kidney, then cut through layers of tissue to get to the tumor. After excising the tumor and a safety margin around it, he deposited the tissue into a special bag and removed the bag through an incision in Allaire’s abdomen. 

Next, Mittakanti reconstructed the kidney and surrounding area, stitching the tissue and the blood vessels back together layer by layer. 

Allaire spent one night in the hospital and says she felt healthy enough to return home the next day. The tumor was not cancerous and follow-up ultrasounds of her kidneys have been clear. 

A short time later, however, a cyst was detected on her left ovary, and Allaire was referred to Dr. Elizabeth Clark, an obstetrician/gynecologist at Montage Medical Group who also specializes in robot-assisted surgery. 

“We monitored the cyst for a while, but Jamie kept having significant pelvic pain,” Clark says. “With that type of persistent pain, the best way forward is surgical.” 

Clark suspected that Allaire also had endometriosis, a painful condition caused when tissue similar to the lining of the uterus grows in other areas. During the surgery to remove the cyst, Clark confirmed the endometriosis and removed the pain-causing tissue. 

“What I really like about robotic surgery is the camera, with its high-definition, 4K images in 3D,” Clark says. “You also have 360-degree range of motion with your instruments. I’m able to operate with more dexterity, in a more timely fashion, so there’s less time under anesthesia and limited blood loss.” 

The surgery required only four tiny incisions and Allaire went home right afterward. At one time, removing an ovarian cyst required open surgery, with a large incision and a hospital stay.  

“Laparoscopic surgery made a big jump in advancement,” Clark says, “and I think robotics has taken it a step beyond that.”