In August, Dartmouth Hitchcock Medical Center became the first New England hospital north of Boston to offer minimally invasive robotic surgery for the heart’s mitral valve. The surgeries are performed using one of DHMC’s five da Vinci Xi surgical robots, operated by Dr. José Rodriguez Tu’25, who has 17 years of experience working with robotic surgical systems. The Dartmouth sat down with Rodriguez to discuss the system and the future of healthcare in rural areas.
What is the benefit of using these robots for surgery?
JR: In standard surgical procedure, you open the sternum to do the surgery on the mitral valve. There’s a recovery phase: You cannot drive for a month; you cannot push anything heavy with your chest for two months to allow the breastbone to heal.
With these minimally invasive surgeries performed using robots, we can do small incisions. We don’t need to split the breastbone, so patients can go back to the community, back to work. They don’t need to miss as many work days as when standard surgery is done.
How does the robot operate?
JR: I put my fingers on the robot’s instruments and they replicate my movement. The instruments inside the patient are very, very small, and they will replicate the movements that I do in the console. So you see three times magnification. You see three-dimensionally. And, the technology is getting much better. Now, you get haptic feedback, you feel the robot in your hands. You feel that a substance is soft or hard, rather than relying on visual identification.
How have surgeries using the robot at Dartmouth gone so far?
JR: It’s not difficult to deploy a new robotic program here. We have great intensive care unit. We have great nursing. We have great physician assistants. We have great partners. We have a great cardiology program already. So I was able to bring in the robot platform in two and a half months ago with all the other moving pieces already together.
Dr. Henry Tannous has been trying to prepare the team for this day for the last year. Just putting the robot in, bringing the patients and doing surgery, was not difficult — so the outcomes are excellent.
What did patients do before DHMC purchased the robot?
JR: Patients were traveling hours to Boston or New York to get this surgery done. We have adequate care in the United States, but the state-of-the-art technology is not in every hospital, because not every hospital has the financial power to buy a $2.5 million robot and they don't have all the physicians to use it.
Will other rural areas have access to surgical robots in the foreseeable future?
JR: If things continue the way they are, with more cuts of reimbursement to hospitals and the prices of equipment continuing to go up, I don’t think so.
The question is how we make it possible that you don’t need to drive ten hours to get robotic surgery. I just finished my Masters of Health Care Delivery Science at Tuck School of Business, and I’m happy that I’m doing robotic surgeries here now with the rest of my colleagues. We are providing robotic surgery for the entirety of New Hampshire and some parts of Vermont. Right now, I have patients that travel two hours, but otherwise would need to drive four hours to Boston. They still need to travel, but less.
When you have family members with you and you stay in the hospital for three days, that’s a lot of travel for those family members. It makes it very difficult when they work and have kids. We need to try to figure out how we can make [these surgeries] more accessible for the nation.
This interview has been edited for clarity and length.
Jackson Hyde '28 is a news reporter. He is from Los Angeles, Calif., and is majoring in Government modified with Philosophy.
