BUSINESS

da Vinci® Xi Robotic System

For Modern Mini-invasive Surgery Techniques The Nový Jičín Hospital, a member of the AGEL group, the Centre of Highly Specialised Oncology Treatment of Adults in Nový Jičín (Centrum vysoce specializované onkologické péče pro dospělé Nový Jičín) provides training in robotic surgery to doctors from all over Europe. We have interviewed Dr. Matej Škrovina, Ph.D., FEARCS, Chief of Surgery, expert guarantor of surgery at AGEL Group, and proctor for robotic colorectal surgery. Mr Škrovina, you have dedicated your life to surgery. How did you get involved in robotic surgery in particular? What attracts you to this specialization? I wanted to become a surgeon since before my studies of medicine at Comenius Universityin Martin. Having graduated, and having finished the compulsory military service, I started working in the surgery at the Hospital and Health Centre (NsP) in Žilina in the spring of 1995. That was one of the first health centres in Slovakia to operate a laparoscopic set, which facilitated my practical experience with mini-invasive surgeries even during my very first surgeries. I had a great opportunity to specialize in this surgical field and develop my laparoscopic skills when I changed jobs: in 2003 I began working as a qualified surgeon at the Centre

of Vascular and Mini-invasive Surgery of Podlesí Hospital in Třinec (Centrum cévní a miniinvazivní chirurgie Nemocnice Podlesí a.s. v Třinci). This department has been a famous pioneer and leader in laparoscopic surgery in the Czech Republic. This is where I earned my first experience with laparoscopic surgeries of cancer of the large intestine and rectum. Growing interest in this field of surgery made me change employers again and I became the medical director of the colorectal team at the Surgery Department at Nový Jičín Hospital (Nemocnice Nový Jičín a.s.) in 2005. In 2010, having finished certified training in Strasbourg, I started robotic colorectal surgeries. The system da Vinci® Standard used at those times had its limitations, yet I saw robotized surgery as highly prospective and very promising. I admit that since 2016 I have been truly passionate about robotic surgery when our department, as one of the first health centres in the Czech Republic, obtained the fourth generation of the da Vinci® Xi system installed. With further development of the robotic system and new instrumentation, with increasing experience, its implementation gets wider. I am convinced that robotic surgery is the right direction for surgery in general the near future, especially with surgeries of particular diagnoses with a particular group of patients. You work in the Nový Jičín Surgical Department of the Centre of Highly Specialised Oncological Treatment of Adults (Centrum vysoce specializované onkologické péče pro dospělé Nový Jičín) which was awarded the prestigious European accreditation status “Case Observation Centre“ in colorectal surgery. This status allows the hospital to let surgeons from all over Europe come, learn and perform robotic surgeries of the large intestine and rectum. Can you describe the structure of such training? Education in robotic surgery has a few stages, and differs with a console surgeon and with an assisting surgeon. Firstly, the console surgeon is the surgeon already experienced in colorectal surgery. The first stage consists of learning the technicalities of the operation with the robotic system as well as training surgical skills on a simulator, which is part of the console of our robotic system. Having achieved a certain success rate, the surgeon proceeds to the next stage, which is training surgical techniques of a particular surgery with special piglets and cadavers. Only a few modern teaching centres of laparoscopic and robotic surgery provide this type of education and training. One or several visits

36 ǀ POSITIV 3/2019