Robot makes surgical history

Thursday, March 25, 2004

By PAT STANLEY
Register Correspondent

Medical history was made at Napa's Queen of the Valley Hospital this month, when Dr. Rebecca Jackson performed the world's first robotic-assisted plastic surgery.

Using the hospital's new daVinci robotic surgical system, the Napa surgeon successfully performed a breast lift on a 38-year-old San Francisco woman.

"It's just unbelievable," the doctor said of the $1.4 million robot, one of only about 200 in the world, half of which are in the United States. "I made only three incisions, no larger than the width of a finger. That means small scars, less discomfort and less time (in surgery)," she said.

The patient, Jenny Lefferts, a mother of three and a map maker, was back to work in two days and says she is totally satisfied, although, "I'm not doing cartwheels yet but I feel a lot better."

Using the robotic system at the Queen, the surgeon inserted tiny sleeves through the flesh: Two for surgical instruments and a third to accommodate a camera the width of a pencil that allows the surgeon to see inside a person in 3-dimensions and color.

"With instruments attached to the robot, the arm can be as long as needed," she noted.

Jackson said she spent much of last year in the lab figuring out just how to adapt the procedure, known as a mastopexy, to be performed by the robot.

What does the future hold for robotic surgery? "More complicated procedures," she said. "Maybe a mastectomy. For breast reconstruction there will be great advances. I think it's going to be the future."

As a child, Jackson said she always knew she would be a doctor, but she never could have imagined the recent advances in medical science.

She was born in Ohio, where her father was a small town general practitioner. "He made house calls," she said.

The first time she saw the results of cleft lip surgery she knew she wanted to specialize in plastic surgery. "This surgeon took a baby and reconstructed him," she said. The infant's upper lip and much of his face was terribly distorted, but he looked normal following surgery. "It makes this huge impact on lives. It's really gratifying."

Jackson earned her medical degree at the Medical College of Ohio. She completed a residency in plastic surgery at Stanford, and continued her studies in microsurgery under a fellowship at Davies Medical Center in San Francisco. The doctor was certified by the American Board of Plastic Surgery in 1994 and started her Napa practice the same year.

Lefferts said she trusted Jackson implicitly. "What makes it cooler is I've known Becky for more than 10 years but hadn't seen her for ages," the patient said.

The two women were catching up on old times during a visit to Jackson's home last summer when the topic came up. "She said she wanted to do a breast lift (by robotic technique)," Lefferts recalled. "I have had three kids, and in the back of my mind there was this ding, ding, ding. I knew I wanted to be the patient. It helped enormously that I knew her. Her skills are so great."

Would she recommend such a procedure to other women? "Absolutely. I never would have had it done (the standard way). The scarring with that is astronomical. I have very, very small scars and they are already healing."

Lefferts operates Mad Maps (see madmaps.com), a company that makes maps for back road trips by car, RV and motorcycles. She works out of her San Francisco home.

The robotic system was first used at Queen of the Valley Hospital in December of 2002 when doctors removed the thymus gland from a 22-year-old suffering from a debilitating disease that made it difficult for her to swallow, smile or even move her arms and legs. The patient, Lotasha Thomas, quickly agreed to the robotic surgery when told it would mean doctors would not have to cut through her tattoo of a flying panther, leaving a 12-inch scar on her chest.

Since then Queen of the Valley Hospital has used the robotic technique primarily for urological and cardiac procedures, allowing surgeons to probe inside the body with minimally invasive entry.

Doctors at the Napa hospital continued to break new ground, however, by using the technology for Northern California's first robotic-assisted coronary artery bypass, the state's first robotic procedure to remove a kidney mass, and procedures to treat reflux disease.

"It is a really wonderful tool," Jackson said. "Something to be embraced."

"This is a new technique, and probably the future of surgery," she said. "It will probably become very mainstream. It's really wonderful -- something to be embraced."

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