Wednesday, October 31, 2012

Student Innovator: Scrubbing In--My First Robotic Surgery and the Role of Technology in Innovation

As part of the institute’s commitment to education, each year we host a class of Student Innovators who spend the summer working side by side with our investigators. Larry Kim, one of those student innovators, periodically shares commentary about his time with us.

I recently observed my first surgery at Children's National and let me tell you, it was absolutely unreal. To stand side by side with the best surgeons, nurses, and technicians in the world was an honor. As a public health professional with little clinical experience, this was an unbelievable opportunity to learn about pediatric surgical innovation. It was an experience that would have otherwise be unavailable to me had it not been for the Summer Student Innovators Program.

The surgery performed was to create a flap valve at the base of the ureter near the bladder. A ureter is a tube that transports urine from the kidneys down towards the bladder. Vesicoureteral reflux, or kidney reflux, is caused when there is an abnormal flow of urine from the bladder back up towards the kidneys (Figure 1). The newly created flap valve would allow urine to move freely from the kidney down to the bladder, but prevent the back flow of urine.

The Da Vinci Surgical System (DVSS) was utilized to create this flap valve to treat vesicoureteral reflux. The DVSS is a minimally-invasive surgical robot that requires only three small puncture sites (two for the surgical arms and one for the video camera) to operate successfully. The surgeon operates the DVSS and its surgical arms from an operation console located across the operating room. Through the operation console, the surgeon can manipulate two controllers, one with each hand, and have each surgical arm of the DVSS move concurringly.

To see the DVSS in action was a thrill. To have the opportunity to sit behind a secondary operation console and watch the surgeon operate in live in 3-D was a dream. It was astonishing for me to see the collaboration between man and machine. I was impressed with how the DVSS could become the extension of a brilliant surgeon’s hand, and in turn, elevate the skills, experience and expertise of that surgeon.

This endearing relationship between man and machine reminded me of the popular movie "Iron Man." In the movie, an engineering prodigy named Tony Stark develops a super human suit. Alone, Tony Stark is an intellectual genius. But it was only when his skills, experience, and expertise were combined with the limitless potential of technology that he elevated himself to superhuman levels.

Today, I watched a pediatric surgeon by the name of Craig Peters, MD, accomplish this same super-human feat. Dr. Peters on his own is an accomplished and well-respected surgeon in the field of pediatric urology. The DVSS allows Dr. Peters to perform these surgeries without the need for a large incision site and allows the patient to recover sooner and with less pain than with traditional open procedures. This example illustrates the early stages of the limitless potential for technology to change medicine. Technology can make a surgeon super human, and has the capability of making the impossible possible.

Tuesday, October 16, 2012

Washington Post: Kids and needles is sometimes a good match: Acupuncture can help with pain

Recently, Sarah Rebstock, MD, Children’s anesthesiologist and clinical director of the Pain Medicine Clinic, a program of the Pain Medicine Initiative at the Sheikh Zayed Institute, was part of an article about the increasing use of acupuncture to treat pediatric pain.

The story focused on one patient, Victoria Rust, who has been seen by the institute’s pain team and also received acupuncture from another Children’s anesthesiologist, Jennifer Anderson, MD. The acupuncture treatments helped Victoria’s pain. Additionally, Victoria reports that since starting a comprehensive pain medicine program, including acupuncture and other integrated therapies like psychological support with the pain team, she has been able to avoid a lengthy hospital stay (something she’s had many of in the past).

Dr. Rebstock advocates for the inclusion of research-based alternative therapies, including acupuncture and aromatherapy, that can help children cope with their pain. A comprehensive pain medicine program is designed for each child who is treated by the pain team, based on the unique needs of that child and his or her family.

Read the article here, and stay tuned for more news about our pediatric pain initiative in the coming months.

Tuesday, October 9, 2012

Immunology research: More clues to why the body can't fight tumors

A joint research study published in the Journal of Immunology from researchers in the Immunology Initiative of the Sheikh Zayed Institute for Pediatric Surgical Innovation and the Center for Cancer and Immunology Research at Children’s National has identified gangliosides as another piece in the puzzle around why the body’s natural immune system, led by CD8+ T-cells, or “killer white blood cells,” is unable to effectively combat tumors. Gangliosides are a constituent of all cells, but are shed in tremendous amounts by tumor cells as they grow and divide. They have been shown in previous studies to have inhibitory properties, but this study is the first to definitively show how they diminish the function of the killer t-cells.

“Our next step with these results is to find a way to alter CD8+ T-cells so they are not susceptible to these inhibitors,” said Sasa Radoja, PhD, from the Immunology Initiative.

Read the press release for more.

Read about Dr. Radoja's previous research studies.

Monday, October 1, 2012

WUSA9: Robotic Surgery in Pint-Sized Patients

Our robotic surgery expert, Craig Peters, MD, recently was featured in a story about surgery using the da Vinci Surgical System at Children’s National. The robot was made possible by the Sheikh Zayed Institute, and Dr. Peters came to Children’s in 2010 specifically to work with our bioengineers to improve robotic surgical options for kids. As you can see from the video, this work is already benefiting children. Watch it at WUSA9 by clicking on the image above.