UCSF Health Reaches 15,000 Robotic Surgeries

Gastrointestinal cancer surgeons at the UC San Francisco have performed the health system’s 15,000th robotically assisted minimally invasive surgery, making it the first University of California health center to reach this milestone. UCSF Health has the busiest robotic surgery program in the UC health system and is the leading academic medical institution for robotic surgeries in the western U.S.

The milestone surgery was a robotically assisted duodenal resection performed by Mohamed Adam, MD, a UCSF hepato-pancreato-biliary cancer surgeon who specializes in using minimally invasive robotic techniques. The patient was Elena Ceja, a 52-year-old woman with a gastrointestinal stromal tumor. Adam performed the surgery with the da Vinci Surgical System, in use for many robotic procedures at UCSF.

“With traditional open surgery, a resection of the third part of the duodenum can be very complicated and result in a prolonged hospital stay,” said Adam, assistant professor in UCSF’s Division of Hepatobiliary and Pancreatic Surgery. “The patient has difficulty eating and ends up staying in the hospital for several weeks because they need intravenous nutrition and time to heal from their incisions.”

Duodenal resection is a type of surgery for patients with cancer in their small intestine. While this procedure can be performed either traditionally or robotically, a robotic duodenal resection can be performed through a series of small incisions that result in less pain and scarring, a shorter recovery time and a lower risk of infection.

“Her tumor was close to the superior mesenteric artery and the superior mesenteric vein that feed and drain the bowel,” said Adam. “Accessing that area is very difficult and can be a very delicate surgery. Using the robot’s camera, I had a very clear view of the tumor, the colon and the surrounding tissue. It allowed me to make a smaller incision without putting retraction on the colon and tissue.”

Use of the robot during surgery improves visualization of the surgical field through 10 times magnification in 3D and enhances dexterity for manipulation and dissection of tissue with greater precision. While robotic instruments manipulate tissue, surgeons like Adam use the robotic surgical system to guide the robotic arms and movements of the surgical instruments.

In Ceja’s case, Adam was able to completely remove her tumor, and she was able to leave the hospital after five days. Since the surgery, Elena says she is feeling good, and her recovery is going well. Adam notes she is tumor free and will continue to be evaluated, but she will require no further treatment or surgery.

Embracing innovation with a range of robotically assisted surgeries

In addition to the robotically assisted duodenal surgery, Adam also has expertise in robotic pancreaticoduodenectomy, also known as the Whipple procedure, used to treat certain cancers of the pancreas and bile ducts.

These robotic surgeries, as well as a number of other robotic procedures, put UCSF surgeons in select company. Only a few facilities on the West Coast have the number of robots and robotically trained surgeons as UCSF Health. In 2023, UCSF surgeons performed more than 2,000 robotic procedures and the health system is on pace for 2,500 robotic procedures in 2024. With nine dedicated robotic operating rooms and 59 UCSF surgeons doing robotic procedures, UCSF Health has become the leader in innovation and minimally invasive surgery in San Francisco and the Bay Area.

“We were one of the first institutions in the western U.S. to do robotic surgery, and we stay very up-to-date and are always incorporating the latest robotic technologies,” said Johannes Kratz, MD, a thoracic surgeon and medical director of UCSF’s robotic surgery program. “We have been able to reach this milestone of 15,000 robotically assisted surgeries thanks to UCSF Health’s commitment to incorporating the latest advances in medicine to better the care of our patients.”

Robotic surgeries currently being performed at UCSF encompass a wide range of specialties and procedures, including removing cancerous tissue from the lungs, uterus, ovaries, colon, rectum, esophagus, bladder, prostate, head and neck, liver and pancreas. Other robotic surgeries are used for cardiac mitral valve repair, the treatment of uterine fibroids and endometriosis, female pelvic organ prolapse repairs, hernia repairs and bariatric surgery.

UCSF Health has also recently added a robotic donor nephrectomy program, a robotic sleeve gastrectomy program and an outpatient robotic surgery program. The health system has also added new single-port robots and robotic bronchoscopes.

“Our excellent outcomes in robotic surgery reflect the experience and excellence of our team,” said Kratz. “Robotic-assisted surgery is one of the minimally invasive surgical approaches we use to make medical care safer and recovery easier.”