Evolving surgical technology could help in opioid fight

Count On Health

LITTLE RIVER, SC (WBTW) – Evolving robotic technology in local operating rooms could prove beneficial in the fight to decrease the number of first-time opioid users.

The Da Vinci Robotic Surgical System is providing a less-invasive alternative to traditional and complex open surgeries, resulting in smaller post-op opioid prescriptions.

“The technology allows us to work in a very small space with very precise instruments,” explained Dr. Nicholas White, a general surgeon with McLeod Health, who has used the system more than 200 times. “The Da Vinci robot translates everything into a 3-D image. It’s almost like I’m inside the (patient).”

The Da Vinci system allows a surgeon to control instruments used in a procedure from a console, which mimics their hand movements in real-time. Dr. White says the precision of the robotic-assisted surgery causes less internal trauma than traditional open procedures.

He’s found it’s led to less pain, shorter hospital stays, easier recoveries and how he’s prescribed some post-op painkillers. “For the patient, it’s been very interesting. I’ve been recording my data over the last year and a half and we’ve seen there’s less narcotic usage,” he said. “

Initially, when I was doing a laparoscopic cholecystectomy or a hernia repair, my typical number was 21 tablets. I cut that down to about 15 and continue to cut that down to see what my patients truly need.”

Opioids – like Percocet, OxyContin and Vicodin – are often prescribed to help patients manage short-term post-op pain. A University of Michigan Institute for Healthcare Policy and Innovation study found the most common post-surgical complication is becoming a new chronic opioid user.

“With up to 92% of patients having leftover opioids after common operations, millions of pills are left vulnerable to diversion into communities,” the study said. Both doctors and police say, if not used as prescribed, these opioids can be a gateway to possible addiction.

Furthermore, the police officers and doctors News13 spoke with said they think smaller prescriptions could impact first-time use and the number of pills turning up on local streets and contributing to the opioid epidemic.

Dr. White told News13 he sets expectations with his patients ahead of surgery so they know the caliber of pain they’re expected to feel. “Ten years ago, you may have gotten two to three refills. We don’t do that anymore,” Dr. White noted. “I really try to educate my patients saying you may not need as much. I’m not going to write you as much and having that knowledge beforehand – patients are preparing for that.”

Mark Scott’s doctor at McLeod Health prepared him for much of the same when he had a hernia repaired earlier this year. His surgeon used the Da Vinci for robotic-assisted procedure, and afterward, Scott described the pain as “more of a discomfort.”

He was prescribed an opioid in case the pain from the surgery was too much, but he didn’t take a single one. “I threw them away. Basically, I took a couple of Advil each night before I went to bed, mainly to calm myself down,” he said. “I think it’s incumbent on the doctors to explain exactly what this is and why it’s being prescribed. The patient has to be accountable in that – in my opinion. They have to inform themselves and educate themselves about what this is going into (their) body and the potentials because, you know, it could very quickly get out of hand.”

While Dr. White does encourage his patients to at least fill their post-op prescriptions, he advises them that if they don’t need the medicine for more than 24 to 48 hours, to discontinue use.

With that said, he’s noticed another interesting trend. “A lot of patients come back to the office and say, ‘I have all these pills leftover,’ and I tell them to take them to their local pharmacy,” he said. Dr. White says that’s a major advantage to this ever-evolving technology that could show up in more hospital systems across South Carolina.

McLeod Health has performed more than 1,700 robotic-assisted surgeries in the Grand Strand and Pee Dee since November 2013. Located at McLeod Regional Medical Center in Florence and McLeod Health Seacoast in Little River, the Da Vinci systems are used for a wide range of procedures including gallbladder removals, hernia repairs, colon removals, reflux disease, hysterectomies, lobectomies and lymph node dissections.

Copyright 2020 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.