Maurice Lyons remembers when lung surgery used to require him to make a 6-10 inch incision in a patients' skin and fracture a rib. He'd take the lung out, do what needed to be done and put it back. It would take patients about a week to recover enough just to leave the hospital, Lyons said.

Robotic surgery changed that.

North Colorado Medical Center began using robotic surgery several years ago, Lyons said, but recently invested in new technology. The hospital purchased a new $1.9 million robot that specializes in thoracic (lung and chest) surgery, and about $60,000 on a special bed that can electronically communicate with the robot to tilt and shift for better angles.

The older model worked well for fixed organs, like uteruses and prostates, Lyons said, but didn't work as well for surgery that involved multiple organs or organs that move around. Lyons, a chest and lung surgeon with NCMC, decided it was worth taking the time to learn how to do robotic surgery. It took some time to learn, but ultimately Lyons said it benefits the patient.

"With the robot, I can go through a hole the size of a pen," Lyons said. "It's the same access with much smaller points." The hospital recovery time is just a few days, much less than a week, Lyons said, and the procedure is just as effective. NCMC started using the new robot in November. They've operated on more than 100 patients since then.

"It's improving the safety of our patients and the care they get," Lyons said. "It's not always easy for hospitals to invest in this environment of uncertainty (around healthcare)." 

The new model, the da Vinci Xi Surgical System, has a better range of motion than the previous model, the S1, Lyons said. The robot and the table can communicate to shift the patient, and therefore the organs, as needed, which is important for things like bowel surgery. When Lyons performs the surgery, he isn't standing over the patient. Instead, he sits several feet away with his head down looking at a screen. The screen shows a 10 times magnified version of what the robot is doing. He can see blood vessels in great detail. He controls the robots fine movements with his fingers and a foot pedal.

It's nice for the surgeons, Lyons said. He doesn't have to stand hunched over patients for long hours. The robot has safety measures in place, so if he looks away from the screen, the robot stops following his movements. Lyons started training on the new robot in October. He spent a couple days in Atlanta practicing on pigs and then human cadavers. So did his team.

Liz Dasher, surgical assistant, said many patients they see for bowel surgery often stay in the hospital for 24-48 hours when they used to stay for 5-7 days. 

"It's a huge step," Dasher said. The procedure itself takes a little longer, Lyons said, but its an investment in less pain, Lyons said.

It also can reduce the risk of infection, Lyons said, since a smaller open wound creates less potential for one.

Lori Sterbenk, manager of perioperative services at NCMC, said the hospital doesn't get any additional revenue for using the new robot versus the old one, though insurance companies could potentially bill it differently.

It was an investment in clinical outcomes and patient care, Sterbenk said.