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Penn State Hershey is second in nation to offer new robotic surgery

Penn State Milton S. Hershey Medical Center is only the second institution in the nation to use a new robotic surgical device just approved by the FDA in October for head and neck surgery.

Dr. David Goldenberg, professor and chief of otolaryngology and head and neck surgery, will be the second U.S. surgeon to perform an operation using the Flex Robotic System, which makes it possible to easily access locations in the body that were previously difficult or impossible to reach using minimally invasive techniques.

Robotic surgery as a whole is minimally invasive, which means that because patients have fewer and smaller incisions – if any – they have less pain and faster recovery and discharge.

Dr. Stephanie Estes, Penn State Hershey’s director of robotic surgical services and associate professor of reproductive endocrinology and infertility, said the robotics program at Penn State Hershey has grown since its introduction in 2009 to include four DaVinci robotic surgical machines and more than 25 surgeons who complete minimally invasive procedures.

“You can see how far it has come,” she said. “We are expanding to become leaders in this field because we want to have more minimally-invasive surgery for everyone. The goal is to take care of patients’ problem and get them back to their lives and doing what they want.”

In August, Goldenberg flew to Germany to watch the device in action and perform a live surgery with it. When the FDA approved the system for use in the United States, purchase at Penn State Hershey was made possible in part through a gift from the Benjamin Olewine III family. Goldenberg’s department covered the rest.

In the past, head and neck surgeons had to saw open a patient’s jaw like a book in order to access areas they needed to operate on. With the advent of the DaVinci robotic surgical system several years ago, that was no longer necessary.

“I’ve used the DaVinci for the last four or five years, but it is large– about the size of a VW bug – expensive, and a linear system. The camera needs to be switched out every time I want to look in a different direction which takes time,” Goldenberg said. “This new device is like a snake made from Legos, so under my control, it can go exactly where it needs to be, it looks wherever I want to look and the instruments are right there in front of me. I can work under direct visualization.”

The Flex Robotic System’s flexible camera provides magnified high-definition views while navigating nearly a 180-degree path. Surgeons can overcome the limitations of straight surgical tools to extend the reach of what they can do.


Goldenberg said the device will be used for oral cavity, oropharynx and larynx surgery. It may be useful in skull-based surgery as well.

A robotic surgical device is a tool and figured into routine costs of conducting surgery. A patient who could benefit from robotic surgery does not pay more for the surgery and the Flex system overall is more cost effective than the current robotic technology for ENT procedures, Estes said.

“This is a lot smaller, less expensive, easier to set up and very flexible,” Goldenberg said. “You don’t need an extra assistant at the bedside because this gives you better control of the instruments during surgery and it can be done by one surgeon.”

Although the Flex Robotic System is currently only approved for use in head and neck surgery, Goldenberg expects it will eventually be approved for use in procedures through any natural orifice: “I think it will be good for esophageal work and toward the stomach, colorectal and gynecological surgeries.”

Estes, who performs advanced gynecological surgeries as well as in-vitro fertilizations, is planning to start research and clinical trials that she hopes will eventually lead to FDA approval to use the device in other types of surgeries.

Estes said the new technology matches with the organization’s vision and mission.

“We don’t want to just keep doing things the way we have always done,” she said. “This is what we should be doing for our patients because as an academic institution, our goal is to be leaders in the field of technology growth for optimal patient care. We’re always looking for new innovations that will lead to products that help us do that.”

For an appointment, patients can call Careline at 800-243-1455; physicians and staff can call MD Network at 800-233-4082.

  • Jennifer Vogelsong




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