Photo by Deb Gau General surgeon C.N. Eisenhauer adjusted one of the four robotic arms on the new da Vinci Surgical System at Avera Marshall. The arms can hold surgical instruments, which are controlled by a surgeon at a console in the operating room.

MARSHALL — It sounds like science fiction.

Since this fall, some patients at Avera Marshall Medical Center have had surgery with the help of a robot in the operating room.

In September, Avera Marshall began offering robotic-assisted surgery for some procedures. The new equipment helps the hospital offer more options for minimally invasive surgery, said Dr. C.N. Eisenhauer, a general surgeon at Avera Marshall.

“We’re doing this to expand the services we can offer to our patients,” Eisenhauer said.

General surgeons and obstetrician-gynecologists at Avera Marshall are now using a da Vinci Xi Surgical System for some operations. The new surgical system has four robotic arms that can hold a variety of surgical instruments. A surgeon working at a console in the operating room controls the arms’ movements.

Being able to have access to robotic-assisted technology in southwest Minnesota was exciting, said Josh Lugar, director of surgical services and specialty clinics at Avera Marshall. In the past, some of the closest places where robotic-assisted surgery was available were cities like Sioux Falls, Willmar or Mankato.

Lugar said Avera Marshall is only the second Avera hospital, after Avera McKennan in Sioux Falls, to have a da Vinci surgical system.

The da Vinci system was installed at Avera Marshall in April, Lugar said. However, it took months of training and preparation for the surgical team before the system could be used.

Eisenhauer said performed the first surgery using the da Vinci system at Avera Marshall in September. Since then, a total of about 20 operations at the hospital have been done using the system, Lugar said.

Robotic-assisted surgery evolved from laparoscopic surgery, Eisenhauer said. Laparoscopic surgery uses instruments like tubes and tiny cameras in order to do surgical procedures without having to make a large incision in a patient’s belly.

“There are technical limitations to laparoscopy,” Eisenhauer said. “That’s where this platform was born from.”

Eisenhauer said the da Vinci robot gives surgeons a wider range of movements and more precision than they normally would have when using laparoscopic instruments. The new system helps make it possible to do more complex surgeries, he said. Some examples of operations that can be done with the robotic-assisted system include prostate removal, hernia repair, gynecological procedures like hysterectomies, and colon resection surgery.

Minimally invasive surgery has significant benefits for patients, Eisenhauer said. Patients have less pain, shorter hospital stays, and can return to normal activity faster after surgery.

“It’s really quite impressive to see how well patients tolerate these procedures,” he said. There is also less risk of complications like infections, he said.

On Tuesday, Eisenhauer and Lugar showed how the da Vinci system at Avera Marshall worked. The system has two main parts: a cart with robotic arms that are put into position near the patient, and a control console for the surgeon. The controls have loops that fit around the surgeon’s fingers and thumbs.

During surgery, “The motion of our hands gets translated to the movement we see on the instruments,” Eisenhauer said.

Other controls at the console have foot pedals. Eisenhauer said using the surgical system controls was a little bit like playing an organ — but instead of looking at sheet music, the surgeon is looking through an eyepiece at a magnified, 3-D view of the inside of the patient’s body.

Eisenhauer said that when he’s working with a patient for an elective surgery, he will discuss robotic-assisted surgery if it’s an option for them. Whether or not it’s an option can depend on factors like an individual patient’s condition, the type of surgery they need, and the availability of the equipment.

The robotic-assisted surgical system takes some time to set up, so it isn’t used for emergency surgery, Eisenhauer and Lugar said.

Eisenhauer and Lugar said it took commitment from the Avera Health system to bring a da Vinci system to Marshall. The new equipment will allow surgeons to provide area residents with more options, closer to home.

“I think that’s the best part about it,” Eisenhauer said.