Mount Sinai Health System announced this week it has established the Mount Sinai Robotics Institute (MSRI) to advance patient care and augment research and training. Since the first minimally invasive robotic surgery to treat head and neck cancer at Mount Sinai in 2008 surgeons at Mount Sinai have been on the forefront of pioneering robotic surgery techniques.
Groundbreaking work such as new techniques and refinements, and complication reduction programs in these areas has distinguished MSRI as an international leader in robotic and minimally invasive surgery. Educational programs and clinical research programs have been instrumental in achieving outstanding outcomes.
“The purpose of MSRI is to achieve the best results for patients through optimization of robotic technology and multidisciplinary care,” says Ash Tewari, MBBS, MCh, the Kyung Hyun Kim Chair of the Milton and Carroll Petrie Department of Urology at Mount Sinai, co-chair of the Institute. “At our Institute, we will focus on patient education, clinical research and collaboration, and the study of health care outcomes, as well as training, and development of new technology.”
For robotic surgery in head and neck patients, Mount Sinai sends frozen sections of tumors at the time of surgery to pathology, which conducts a rapid turnaround of results while the patient is still asleep. If the cells are positive, the surgeon resects more to ensure margin accuracy. Additionally, the Head and Neck Cancer Research Program has a history of evaluating and utilizing new optical technologies for increased margin control and more precise tumor identification. For example, Mount Sinai was selected as the exclusive site for the Advaxis immunotherapy clinical trial for patients diagnosed with HPV-related oropharyngeal cancers, which is now entering Phase II.
Dr. Tewari developed the robotic prostate surgery technique called Advanced Robotic Technique prostatectomy or ART. ® It is a highly individualized technique that reflects a patient’s unique anatomy, cancer location, and neural structure while removing cancer and minimizing side effects in select patients. Through ART, Dr. Tewari delicately removes the prostate while preserving sexual and urinary function.
In treating patients, Dr. Tewari and his team use a combination of precision medicine approaches including advanced imaging, genomics, and translational research. In addition, Mount Sinai has pioneered the use of NeuroSAFE, an advanced procedure that lets the surgeon know if all the cancer has been excised during the operation itself. It is the only institution in the United States currently using this technology. He also designed athermal and reconstruction techniques to minimize nerve damage during prostate cancer surgery and catheter-less surgery to minimize pain and discomfort for patients.
“The robotic urological cancer surgery program reflects almost two decades of experience and research into mastering and refining the robotic technique in order to ensure we achieve the highest levels of cancer control for patients while preserving nerves responsible for erectile function and continence,” says Dr. Tewari.
Other pioneering surgeons at Mount Sinai have also introduced significant innovations in the field of robotics. The first assistant sparing technique (FAST) robotic partial nephrectomy was developed by Ketan Badani, MD, Vice Chair of Urology and Robotic Operations at the Mount Sinai Health System. It specifically aims to reduce warm ischemia time to the kidney, preserve maximal normal renal function while removing the tumor, and minimize complication risk. The FAST approach has been taught and demonstrated throughout the United States at national meetings and internationally in twelve countries. Dr. Badani has published over 100 peer-reviewed manuscripts on the advancement of robotic technology and improvement in patient outcome.
Mount Sinai is also one of the only locations in the country dedicating a da Vinci Surgical System solely to teach residents and fellows robotic surgery techniques. The majority of users are urological, gynecological, head and neck and general surgeons. In addition, first-year medical students at the Icahn School of Medicine at Mount Sinai have the ability to take a Robotic Anatomy Training Day where students perform robotic surgery on cadavers. The course began eight years ago as the first of its kind in the United States, and Mount Sinai is still one of the only schools in the world to do it.