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Milestone of 2000 robotic surgeries by Texas physician highlights major shift in gynecology care


Milestone of 2000 robotic surgeries by Texas physician highlights major shift in gynecology care

EL PASO - When Dr. Richard Farnam tested one of the first robots for minimally invasive gynecology surgery in 2002 he knew he was participating in a revolutionary advancement in patient care.

“It was something from the future. No one had ever even been able to conceive of a surgery where you can see three dimensions and have little wrists on the end of your robot hands,” he said of the Intuitive Systems robot known as the Standard System that was being tested at the Cleveland Clinic during his residency.

Now, 15 years later, Dr. Farnam has performed 2000 robotic surgeries and has helped establish El Paso as a nationally recognized training center for minimally invasive urogynecology. His individual record of 2000 robotic gynecological surgeries is unique - the kind of milestone that entire hospitals and health care centers more commonly achieve as a group. More people have walked on the moon than have achieved this level of surgery.

“It’s an honor to be one of a handful of surgeons in the country -  and in the world - to have had the opportunity to work with robots for so long,” he said.

Just days before he completed his 2000th robotic surgery on Wednesday, Sept. 20, 2017 at Las Palmas Medical Center in El Paso, Dr. Farnam reflected on how the technology has led to safer, more effective procedures for women.

“There's just something about the robot that benefits everyone,” he said. “ It makes  the surgery and the surgeon better and better outcomes for the patients.”

Advancements in El Paso

In 2005, when the FDA approved the Da Vinci Surgical System for gynecological surgery, most  of the hysterectomies in the U.S. were still being done through an open abdominal procedure. Minimally invasive procedures such as laparoscopy were available, but  medical providers nationwide were slow to adopt the techniques despite well-documented advantages such as  shorter hospitalization, faster recovery, more rapid return to normal activities and fewer postoperative infections.

Providence Hospital brought the first surgical robot to El Paso in 2007, a Da Vinci S system. The following year Las Palmas Hospital also brought in a Da Vinci S system.  Dr. Farnam performed surgeries at both locations and continued to develop his expertise as the technology continued to evolve. Las Palmas was the first to bring the advanced Da Vinci XI to El Paso in 2015 and was the first in the region to integrate inter-operative table motion which allows the operating table to move in concert with the robot instead of having to shift the patient or move equipment during surgery.

Within five years the robots completely changed gynecology treatment in El Paso. Minimally invasive vaginal or laparoscopic procedures for cases like hysterectomies had been available in the city for more than 30 years, yet  the practice of open abdominal surgery remained high. But by 2012, 70 percent of hysterectomies in El Paso were performed using robotic surgery. That’s twice the national average.  

“What we did in this community was we converted from open surgery to a minimally invasive procedure. We finally moved the needle. With robotic surgery  we decimated the open rate and improved quality outcomes for women.”

Promoting Excellence and Innovation

Dr. Farnam, who was one of the first specialists in the nation to receive board certification in urogynecology, performs approximately 8 to 12 robotic surgeries a week for procedures ranging from hysterectomies and prolapse issues to endometriosis surgery.

“It's an amazing privilege to be one of the few who have had this unique experience and the ability to treat that many patients,” he said.

As director of Epicenter for Robotic Surgery at Las Palmas Medical Center, Dr. Farnam  has trained a majority of surgeons in the region who are currently doing gynecologic robotic surgery. The Epicenter is one of just six in the country for gynecologists who want to learn robotics using the Intuitive Systems Da Vinci technology.  

“As part of their pathway to learn robotics they have to come to El Paso, which is such a wonderful development here because 10 years ago everybody was going elsewhere for training,” Dr. Farnam said.

As a champion of excellence in surgical practice, he shares his experience with physicians well beyond El Paso. In April, Dr. Farnam and his team appeared on a live global live broadcast to perform the first hysterectomy in the U.S. using the latest integrated table motion system that works in tandem with the Da Vinci XI. The telesurgery  was broadcast from Las Palmas Medical Center in El Paso to the 200 physicians at the summit in San Diego and to 7,000 American Association of Gynecologic Laparoscopists (AAGL) members worldwide.

Dr. Farnam is grateful that his experience and the support he’s found for his work in El Paso has opened up more opportunities for innovation that can benefit the region and bring major advancements in surgical procedures. In March he became principal investigator on a groundbreaking trial using fluorescent imaging that has the potential to dramatically reduce the risk of ureter injury during surgery.  If the treatment works as expected it would change the standard of care and impact the lives of tens of thousands of women each year.

He credits his achievements to a dedicated team of surgical colleagues,  nurses, techs, medical center administrators and support staff who are committed to excellence. Dr. Farnam, whose wife is an internal medicine doctor who also works full time, considers himself blessed to have the support of his family in his work.

“I think it will be challenging more challenging my if my life partner didn't have a deep understanding of the demands and the commitment it takes to be a healer,” he said.

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