Surgical system uses bits
and bytes to reduce trauma
Center Board OKs 2004 budget, seeks BOV approval
courtesy of Intuitive Surgical
members watched a video of a surgery being performed (such
as the one above) using the da Vinci surgical system, which
the University has just purchased. Using the system, a doctor
operates a console (left) that directs robotic arms (center,
inserted inside the patient) to perform the necessary tasks.
This type of surgery gives a surgeon greater range of motion
and depth perception, and causes less trauma to tissues and
organs, minimal pain and blood loss and greater precision.
At U.Va., the da Vinci System will initially be used for prostate
and heart patients and for gynecology.
By Fariss Samarrai
of the Medical Center Operating
Board got a neat glimpse of some cutting-edge medicine at their
May 8 meeting.
William Steers, chairman of Urology,
showed a three-dimensional movie of prostate surgery as a way
to show off a new $1.3 million surgical robot that will be arriving
soon at U.Va.
is becoming less about blood and guts and more about bits and
bytes, Steers said as board members donned their 3-D glasses.
They watched as a prostate gland was removed by a physician who
was operating from a console on a patient several feet away.
robot, called the da Vinci Surgical System, allows a surgeon to
operate on a patient remotely by using laparoscopic surgery and
operating hand and foot controls at a console. The robots
arms, which have been inserted into the patients
abdomen, include a camera that sends to the surgeon a magnified
3-D view of the operating area inside the body. The surgeon manipulates
instruments at the console that are mimicked by the arms in the
patient. The doctor is able to cut tissue with great precision,
and to cauterize the bleeding areas and sew the incisions.
said this type of surgery will become commonplace in coming years.
It offers a surgeon greater range of motion and depth perception,
and eliminates the tremor of ordinary hands working
in detail in tight places. The surgery causes less trauma to tissues
and organs, minimal pain and blood loss and greater precision.
Paul Mellon Prostate Cancer Research Institute paid for the da
Vinci Surgical System. The Wards Buchanan Fund is providing $1.2
million for related expenses, such as training, additional equipment
and operating room renovations.
system will initially be used for prostate and heart patients,
for gynecology, and could eventually be used for other surgeries.
Steers said surgeons will be able to operate on patients miles
away using the advanced systems of the future.
board also was given a report on the Medical Center operating
budget by Larry Fitzgerald, chief financial officer. Fitzgerald
said the Medical Center is projected to produce an operating income
of $31.6 million for fiscal year 2003, which ends June 30.
expenses for the year are projected to be $601.1 million, $11.8
million more than the $589.3 million budgeted. But a projected
net operating revenue of $632.7 million exceeds the $610.3 million
budgeted, resulting in the projected $31.6 million operating income
net. This is a 5 percent operating income margin.
numbers are based on operating income against operating expenses.
An additional $9.9 million is projected for interest income, resulting
in a projected net income for the year of $41.5 million.
operating income, however $31.6 million is considered
the better measure of Medical Center operational efficiency because
it measures only the profitability of services rendered and not
originally budgeted for a 3.4 percent margin. The projected 5
percent margin is good news for the Medical Center at a time of
rising operational expenses here and nationwide.
also reported that the Medical Center is budgeting for a 4.3 percent
operating income margin for fiscal year 2003-04 and a net income
(margin plus interest) of 5.4 percent. While this provides needed
wiggle room for running the Medical Center budget, it falls short
of the longer-term 5 percent annual operating margin goal set
by the Board of Visitors.
emphasized that the Medical Center is in the business of treating
patients, not making profits. The Medical Center, however, in
order to function with a safe margin must diligently pursue strategies
that accomplish both needs.
income from the center is used for buying new equipment, maintaining
equipment, renovations of facilities, and for paying various debts.
The center generally operates with only 90 days of cash reserves.
Medical Center will need to increase inpatient admissions and
hold down expenses to meet its goals, Fitzgerald said. The center
is adding nine beds to the hospital this year and increasing its
operating room capacity 10.5 percent, with two new operating rooms
opening July 15. To accommodate additional inpatients, the center
also will need to hire additional surgeons. Fitzgerald expects
27,809 inpatient admissions for fiscal year 2004. This is 883
more than this fiscal year. He said the trend is upward for hospital
admissions and that there is a current backlog of surgeries to
Medical Center also is modernizing, using new technologies to
reduce costs. The da Vinci system is one example. Fitzgerald said
the center also is introducing new drug eluting stents, devices
that improve patient care. Fitzgerald said industry experts project
that drug eluting stents could decrease the clinical need of heart
surgery by as much as 30 percent.
Medical Center is increasing its outpatient medical imaging capacity,
opening a new Imaging Center in the new Medical Office Building
2 at Fontaine Research Park.
Medical Center Operating Board accepted the 2004 budget and will
recommend approval by the Board of Visitors.