Dr. Sunil Purohit Discusses Robotic Urologic Surgery

Covington’s Leader in Minimally Invasive Da Vinci Surgery

Dr. Purohit is a highly trained urologist with extensive experience diagnosing and treating urologic conditions with minimally invasive robotic surgery. If you have been diagnosed with a urological condition and are in need of surgery, call (985) 892-6811 to request an appointment at our urology office in Covington, LA today!


 

Video Transcript

Melissa: Hello and welcome to healthy living! I’m your host Melissa Hodgson, and we’re talking today about robotic surgery. We’ll talk with three local surgeons who rely on the robotics Institute at St. Tammany Parish Hospital for the technology that enables them to do minimally invasive surgery. Close to home first well visit with local urologist Dr. Neil. Thanks for joining us today!

Dr. Purohit: Nice to be here Melissa, thank you. I’m excited to be talking about this.

Melissa: You were the early adopter that really tried to talk the hospital into getting into the business of robotics back in the 2000s.

Dr. Purohit: Yes, I remember those days. You know it is a very technical very specifically designed instrument and it’s a very costly affair. So of course when you’re talking to administration when you’re talking to you know the board about you know spending you know one upwards of 1.8 million dollars on a you know technology it’s not that easy it’s not that fun you know. Just a lot of experience in observing all these cases that were done early on in urology and when the robot first came out the FDA approved the robot in 2000 and soon after the major institutions throughout the country were really embracing it in the field of urology prostatectomies and kidneys and things like that and so we you know we had a good feeling that this is going to be the future. We better embrace it or if not then we’re just not going to have it in this area right well. So urology was that area of specialty that could see what robotics could bring to procedures and you’re right obviously in 2000 when it was first approved through the FDA mostly in teaching institutions and major institutions around the country. There were major institutions in Louisiana that had it but only a few.

So when St. Tammany bought their first robot in 2007 that was the first one on the Northshore it was the first one on the i-12 corridor pretty exciting but the hospital stayed engaged in that and that had a lot to do with what you were doing in urology you can talk specifically.

I think about prostatectomy for example before the robot that was something that could not be done minimally invasive. Actually just for example the average blood loss for a open prostatectomy nationally was between one and one point two liters of blood and now with the robot you were talking about 100 CC’s 50 CCS we don’t even type and match our patients for blood anymore because it’s so that has been taken care of as far as a major issue. So what do that entails? You have patients that could be a little bit sicker a little bit older and you know patient that you’d be worried about you know recovering from a open prostatectomy you don’t you can do the same procedure within the minimally invasive fashion and they go home the next day and it’s amazing.

When you look at that as our history from 2007 and then moving forward we’re up to three robots there at St. Tammany Parish hospital.

Melissa: You and your colleagues have achieved quite a milestone in 2019. You crossed the five thousandth case. That’s amazing!

Dr. Purohit: Yeah, and it’s only getting bigger and bigger. As you know, like you said, you started with one robot now we have three. So, that means that you know you have three rooms that are going sometimes at the same time. So as patients come in as the robot continues to evolve we’re able to do more and more complex surgeries throughout the field.

Now cardiothoracic cases are being done robotically specific cases like valves and things like that. There’s a lot of options out there for surgeons and so you know the sky’s the limit.

Melissa: I think it’s really exciting from the patient safety standpoint. Like you were saying much less blood loss a much shorter hospital stay quicker recovery and in urology. Can you kind of outline some of the specific procedures that you as a urologist are able to do as a result of that robotic surgery?

Dr. Purohit: So we talked about prostatectomy. The three advantages for that procedure are:

  • less blood loss: You can actually do what we call nerve sparing prostatectomy, where you can spare the nerves.
  • restored urinary function: For erectile function, incontinence is a big issue when you take a prostate out. Robotically it’s minimized and usually within a few months patients are pretty much back in control of their own urinary function.
  • faster recovery time from kidney surgery: With prostatectomy we went to kidneys now majority of time before the robot kidneys for cancers were being removed in total if you had to do a open partial nephrectomy or open removal of a part of a kidney that was a very morbid procedure you know patients were in the hospital for four or five days now we can do it where patients go home within 23 hours and you know you can basically take the tumor out reconstruct the kidney all within 30 minutes and generally you know what that has allowed is for patients like I said before who are in their you know 70’s and 80’s who have tumors you know you can actually get them through a treatment in a very efficient fashion where they’re home they’re back to their loved ones they’re back on track with their normal activities fairly quickly.
  • minimally invasive pyeloplasty procedure: Another one is pyeloplasty, where we take a stricture and a ureter so we can cut that stricture out and we can hook everything back together. To putting the ureter back there together with sutures and before you’d have this big hockey stick flank incision now you can do it through four little tiny incisions. What does that entail? You know the recovery is again very easy comparatively. Less incision less chance of infection less scarring quicker recovery and that’s what it’s all about.
  • same day vaginal prolapse procedures: Another one that I’m really excited about is vaginal prolapse surgery. So you know a lot of these problems come up when patients in their older years and before you an open prolapse surgery would be a fairly you know morbid procedure in a sense that it takes you know maybe two or three days of hospital recovery etc. These patients sometimes can go home the same day even and I want talking once these patients are older again in their 80s late 70s.

It has really opened the treatment platform for you know patients in the community. It could all be done in a Northshore, they don’t have to go to Houston they don’t have to go to New York they don’t have to go to the South Shore. It can be done in Cummington Louisiana well and we’re excited to be the host facility St. Tammany Parish hospitals robotics Institute. That began with the first purchase of the robot in 2007 has grown and now there’s this wide variety of surgeons and specialists who are able to use it. It does mean that we’re meeting that mission of providing that level of world-class health care close to home on the Northshore.

Melissa: That’s right! Well so now before you go. Can you think in your specialty of urology, what’s the future look like with robotic surgery? What’s coming next?

Dr. Purohit: You know there’s talk about eventually meshing the CT scan with the da Vinci robot on the same platform where you can get an x-ray a cat scan you can find a tumor say in a kidney and basically fill in the coordinates and the robot could actually do the surgery. We’ll have to put the instruments and the patient and and close everything up afterwards but things like that. They’re things where we can actually hopefully be able to inject some medication into the patient intravenously and that might help us identify the nerves for prostatectomies more easily. That’s being done in the lab and hopefully eventually it’s going to come out you know in the real world and small things like that can make huge differences on treatment.

It’s been 13 years since we got into robotics. Started talking about and got into robotics urology has changed tremendously and it’s all centers around the robot.

Melissa: We’ll it’s exciting times thank you so much for coming in and talking with us today!

Dr. Purohit: Absolutely, thank you for having me!

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