Surgical Robot: da Vinci® Xi™

Thanks to huge technological advancements, robotic surgery has developed over the past several years into a proven and growing method of treatment. In 2010, MountainView Regional Medical Center was the first hospital in Southern New Mexico to offer the da Vinci® Surgical System and most recently the latest model, da Vinci® Xi™, has also found a home at MountainView. 

With only a handful of da Vinci® Xi™ Surgical Systems currently in operation in the United States, MountainView Regional Medical Center forges ahead as a leader in the world of robot-assisted minimally invasive surgery. It is the first hospital in Southern New Mexico and West Texas to offer the new and improved surgical robotic device. In fact, MountainView Regional Medical Center is one of only 13 hospitals worldwide to have the da Vinci® Xi™. “We strive to offer our patients the very best in medical care, so we want to stay current with the latest technology that will allow us to do that. The da Vinci® Xi™ provides an option that gets patients in and out of the hospital and back to their lives in a timely manner,” explains Mr. Denten Park, CEO of MountainView Regional Medical Center. 

The da Vinci® Xi™ is a sophisticated robotic platform designed to expand the surgeon’s capabilities and offer a state-of-the-art, minimally invasive approach. This approach has revolutionized many surgical procedures that, in the past, involved significant downtime and extended recovery time. It has become a popular option because it reduces pain, scarring, hospital stays and even complications. With the assistance of the surgical robot, surgeons can now operate using only 1-2 cm incisions and, unlike conventional surgery, with da Vinci® Xi™ the surgeon’s hands never enter the patient’s body. After the initial incisions are made, the robot’s arms make the snips, stop the blood flow and suture the incisions once the surgeon is done. 

“Robot-assisted surgery using this latest technology gives the surgeon a better view of the operation area, with improved clarity and detail, which allows for greater precision when performing surgery in delicate or hard-to-reach areas,” explains Leonard Metildi, M.D. Having performed over 200 surgeries using the da Vinci® surgical system at MountainView, Dr. Metildi is a veteran with over 35 years of experience as a general surgeon. “The Xi™ is a phenomenal machine. As surgeons, we have much better control and it is much more comfortable to use because of it superior ergonomics,” Dr. Metildi adds.

Dr. Ismael Lopez of OBGYN Consultants, is the first doctor in New Mexico to have used the original da Vinci® as well as the latest da Vinci® Xi™. An advocate of robotic-assisted procedures for his patients, Dr. Lopez says: “There are many surgeries in which it is advantageous to use this minimally invasive technique because it may help to reduce blood loss, may yield less post-operative pain and discomfort and less risk of infection, possibly a shorter hospital stay, and less scarring.” Dr. Lopez has performed over 300 robotic-assisted gynecologic surgeries at MountainView.

Although it is widely known as a robot, the da Vinci® Xi™ system cannot move or operate on its own. The surgeon is 100% in control of the surgical robot which translates his hand movements into smaller, more precise movements. While sitting at a console in the operating room, the surgeon peers into binocular-like lenses at 3D high definition views provided by the camera inside the patient. The 3D-HD vision system provides surgeons a highly magnified view, virtually extending their eyes and hands into the patient. Aside from high definition 3D vision and a magnified view, the da Vinci® Xi™ offers the surgeon robotic and computer assistance. They utilize specialized instrumentation, including a miniaturized surgical camera and wristed instruments like scissors, scalpels and forceps. The multi-armed robot also features special “endowrists” that bend and rotate far greater than the human wrist. This new technology is what gives the surgeon that enhanced dexterity, precision and maximum control. 

This past August Intuitive Surgical, Inc., the maker of the da Vinci® Xi™, received FDA clearance of the Firefly Fluorescence Imaging System. This is yet another cutting-edge feature that provides surgeons with enhanced visualization during surgery. The Firefly system enables real-time visual assessment of the vessels and blood flow and allows surgeons to switch between standard, visible light and near-infrared imaging during surgical procedures. 

The da Vinci® Xi™ does, however, have some limitations. Any medical procedure performed with the surgical robot requires that the patient be a candidate for minimally invasive surgery. Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci® Xi™ surgery. Additionally, not all surgical procedures can be performed using this robot-assisted method. At MountainView Regional Medical Center, the most common procedures using the robot-assisted system are cholecystectomy, nissen, hernia repairs, colon, and a variety of gynecologic surgeries. Patients should talk to their doctors and review all available information on minimally invasive surgery using the da Vinci® Xi™ to decide whether robotic-assisted surgery is right for them. 

For Lucia Zimmitti, a Realtor with Steinborn and Associates Real Estate, the experience of having undergone a minimally invasive surgery (performed with the previous model of the da Vinci®) meant that she would have a quicker recovery than with traditional surgery. “My hysterectomy was done on a Monday morning and I was home by Monday evening! I needed strong pain meds for just three days; by the fourth day I only took Advil, and I didn’t even need that beyond a few more days. I drove myself to my two-week post-op checkup and began gentle walks shortly after that. By the six-week mark I felt like my old self and wasn’t restricted at all. I’ve known women who have had the traditional open hysterectomy, and it took them several months to get to the point where I was at just a month and a half. I couldn’t be more pleased with how quickly and smoothly I healed!” explains Lucia. 

The patients are the obvious recipients of the bulk of the benefits; however, the surgeons also stand to gain from using the da Vinci® Xi™. The improved ergonomics of the surgical system allow the surgeons to be comfortably seated through the length of the surgery. Whereas with traditional surgical procedures, the doctor would be standing and bending over the patient putting strain on his back, legs and feet. This advancement has the potential to extent the surgeon’s operating career. 

Dr. Metildi, Dr. Lopez and Dr. Ramirez are all highly trained doctors that utilize the da Vinci® Xi™ at MountainView Regional Medical Center, and they all have several years of experience using this robot-assisted, minimally invasive surgical method. Las Cruces general surgeon Dr. John Ramirez commends MountainView for bringing the newest equipment to Las Cruces. “We are very pleased to have the opportunity to be the first team in the New Mexico and west Texas area to offer this new surgical system. We’ve only started to explore all the capabilities.” 

For more information about da Vinci® Xi™ surgery, talk to your doctor or call (575) 556-6667. You can also visit MountainView Regional Medical Center online at

Fall 2014

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