WRNMMC, Bethesda, Md.  –   The atmosphere inside a urological surgical theater at Walter Reed crackles with electricity as a talented multi-disciplinary team prepares for a historic day, deploying the first single-port robotic system used by any hospital in the National Capital Region, according to Navy Lt. Cmdr. (Dr.) Brandon R. Garren – who championed this novel system.

Transformative Technology Advances Patient Care

“This is one of the most transformative technological advances across disciplines right now, reshaping how we approach surgical disease,” said U.S. Navy Lt. Cmdr. (Dr.) Brandon R. Garren, who along with Navy Cmdr. (Dr.) Gregory Chestnut and the team, performed two minimally invasive surgeries on patients with enlarged prostates.

The single-port (SP) surgical system is like other robots—it has a camera and three instruments—but all of these components fit through a single incision. Once inside, the instruments can splay out, allowing for the triangulation and traction a surgeon needs for robotic surgery.

During the groundbreaking procedures, Garren utilized a console with hand and foot controls to command the robots, while Chestnut meticulously supervised the manner in which the SP performed. Chestnut, who previously served at Memorial Sloan Kettering’s Cancer Center as the Vice-Chair for Quality and Safety, kept the team focused during these intricate operations.

Teamwork, Training and Temperament

For the surgeons, operating nurses, anesthesiologist, and techs - these milestone surgeries represent the dawning of a new medical era for the Department of Defense. “The commitment to bringing the very best technology into our operating rooms is one we all take very seriously,” emphasized Chestnut - recognizing these milestones as the culmination of a storied journey.

“We’ve spent months preparing for this,” remarked Garren. “It’s less about what I do as a surgeon and more about the components we have - the trust we have in one another, and the responsibility we have to the patient.”

Navy Lt. Cmdr. Jessica Schmidt was one of two circulating registered nurses (RN) taking part in these surgeries. Although she’s been an RN for more than 10 years, she acknowledges that the heightened interest in the SP made everyone a bit more self-conscious. “We started our day with high adrenaline, cameras and observers all around us,” commented Schmidt. “To make sure we reduced the stimulus in the room, most of the team kept their music at a whisper as we focused in on the patient’s comfort and vital signs.”

Following the first operation, the patient was astonished to only find a two-centimeter surgical scar. That’s a dramatic improvement on a procedure that historically produced scars three to four times that size and caused much longer post-operative hospitalizations.

“This is a big win for robotic surgery and minimally invasive procedures,” emphasized Garren. “I really hope these successes kickstart the entire field to reconsider how we approach surgery across the spectrum of disciplines.”

Within the Defense Health Agency community, these robotic surgery milestones point to a new era of same-day surgeries, narcotic-free operations, and shorter hospital stays.