Dr. Cristoforo Giulianotti Tracks the Development of Medical Robotics from Rome to Chicago and Back Again
By John J. Otrompke, JD
While Rome may be the site of this year’s annual meeting of the Minimally Invasive Robotics Association (MIRA) (please see live coverage featured in our blog at http://www.medicalrobotics.biz/
as well as print coverage of the most timely and fascinating abstracts and medical news from this conference is our next print issue) as well as in all respects a timeless and world-class city, a windy city several thousand miles away may have garnered the title of capital of the world of medical robotics for 2008.
This is as globally noted robotics surgeon Dr. Pier Cristoforo Giulianotti has made the move to lead the University of Illinois at Chicago (UIC) as chief of the division of general, minimally invasive robotic surgery at the University of Illinois Medical Center.
The move may be considered auspicious for both parties, as UIC has made its Da Vinci robotics program an important marketing strategy, and advertised the program locally, and Giulianotti is also an innovator with the device. Giulianotti is the current president of MIRA, an organization founded in 2003, the same year the first-ever robotic ‘Whipple’ procedure was performed, and also performed the first ever robotic ‘Whipple’ procedure in the Midwest of the U.S.A. recently at UIC.
“The ‘Whipple’ is named after the first surgeon who performed the open resection of the head of the pancreas in the 1940s,” said Giulianotti.
The robotic way of doing surgical procedures is preferable to the open variety, Dr. Giulianotti says. “Patients are clearly volunteering,” he said. If you are asked, ‘Have you any doubt, would you prefer to be operated on for gallstones with three small holes or with open surgery,’ many patients prefer minimally invasive treatment, because its bloodless surgery, post-operative recovery is accomplished in less time, there’s less pain and smaller incisions,” he said.
Speaking directly of the Whipple, Giulianotti said, “In comparison to open surgery for certain steps, using the robot makes it easier; suturing is so precise using the robot,” he said. “You can do some extra movements compared to the human hand, for example,” he said.
Still, Giulianotti believes the state of the art is not yet maximally developed. “It is an economical quandary, because you know there are millions or billions available for developing the market for computer games, so that today’s generation of computer games is absolutely incomparable to the first video games. If only there was the same sort of economic support for developing medical instruments, but unfortunately the market is not so rich. That explains some delay, and some difficulties surgeons still experience, mainly due to the lack of specific tools and the need to develop smaller and thinner instruments, or an inner for scanning and cutting tissue simultaneously, for example,” Giulianotti said.
As a result, Giulianotti has ambitions for medical development during his tenure at the University of Illinois at Chicago. (See sidebar).
While the situation in the European Union is inconsistent or “like leopard spots,” robotic surgery is unfortunately not reimbursed in the EU much better than in the U.S., and this is despite the consistent popularity of the procedures with patients. “At the end of the day and you realize this is very beneficial even solely from an economic point of view. Even consider just the operating costs, it ends up being a little more expensive than open surgery, but if you consider all the elements, including the hospital stay, the readmission rate, the consumption of drugs, and the recovery rate for going back to work, doing procedures robotically has a lot of advantages,” said Dr. Giulianotti who formerly performed operations at Grosseto Hospital in southern Tuscany prior to moving to UIC, and served as chief of surgery and director at the National School of Robotic Surgery before that. (Dr. Coratti from Crosseto will also be presenting at this year’s MIRA conference, Giulianotti said)
Worthy of Note
Expected medical and scientific breakthroughs expected at UIC before the of the year
1. Medical robotics teaching software
2. Research involving two connected robotic surgery consoles, with two different stations working cooperatively on the same patient at the same time
3. A new method of evaluating resection margins in cancer cases (surgeons currently are unable to make their evaluations by touching)
4. An ultrasound device capable of simultaneously scanning with a probe. “Currently, you do not see the vessels depicted on the surface of the liver, but with an augmented reality device which is in development, the imaging becomes available,” said Giulianotti.