A key component of cancer care at SLU Hospital is the availability and employment of the latest available technologies like the remarkable da Vinci Surgical System, a sophisticated robotic platform designed to expand the surgeon’s capabilities while offering a minimally invasive option for major surgery. According to Dr. Helm, “The da Vinci is a computer assisted robotic surgery system, and is just one component of our minimally invasive surgery approach to patient care. It has been a transformation from being able to put tiny instruments into the abdomen to explore and perhaps biopsy things going on in the abdomen, to actually being able to perform complex surgical procedures using laparoscopic instruments that are the thickness of a pencil or pen.”
With da Vinci, small incisions are used to introduce miniaturized wristed instruments and a high-definition 3D camera. Positioned at the da Vinci console, the surgeon views a magnified, high-resolution 3D image of the surgical site. At the same time, state-of-the-art robotic and computer technologies scale, filter and seamlessly translate the surgeon’s hand movements into precise micro-movements of the da Vinci instruments.
“The small incisions are between 5 mm and sometimes smaller to about 12 mm,” said Dr. Helm. “There are many advantages for the patient particularly in GYN oncology. The patient has reduced blood loss, fewer complications, significantly less wound pain, and infection is extremely rare. Minimal invasive procedures generally mean a shorter hospital stay for the patient and most go home the next day.”
In contrast, traditional ‘open’ surgeries can have profound effects to the patient. There is a higher rate of wound infection, increased pain at the larger incision site, a slower return of bowel function, a longer hospital stay, a longer recovery period and delayed return to work. Dr. Helm and his team use the da Vinci Surgical System to treat a range of conditions. “There are three common cancers that we treat—ovarian, endometrial and cervical cancer. The biggest benefit of all is when you are operating on obese patients. The robotic system helps to take the strain off the surgeon, so the surgeon isn’t fighting the instrument going through the abdominal wall. At the same time, the surgeon has the ability to perform very fine procedures deep in the pelvis. The instruments have a much greater degree of rotation so we can get into more difficult places and suture more easily.”
Though not all patients are candidates for the da Vinci, Dr. Helm makes every effort to treat everyone possible with minimally invasive procedures when appropriate. Patients who really benefit are the obese patients with endometrial cancer or obese patients with smaller pelvic masses or adhesions.
Dr. Helm is quick to mention the importance of the multidisciplinary team. “A cancer is something that needs to be managed in a multidisciplinary fashion incorporating the skills of many different specialists. For instance, nutrition plays an important role in patient care so you need to have a nutritionist as part of your team. You also need a genetic counselor to consult with patients who may have a family history suggestive of a genetic predisposition to cancer. Other important members of this team include surgical oncologists with special expertise in liver, biliary and upper abdominal cancer surgery and medical and radiation oncologists. Saint Louis University Hospital has all of this expertise.”
The goals for the patient are shared throughout Dr. Helms’ practice. “Within our group the patient can expect personal service from the physicians and our support staff who care deeply about them. Patients also can expect—and deserve care in a loving, caring, and dedicated environment. “I think that is very important,” said Dr. Helm. “We have a very happy and congenial group of people who all have set out to spend their lives caring for patients with gynecologic cancers. We are all committed to that.” There are very definite benefits for patients in an academic setting like SLU. Dr. Helm adds, “A patient who is cared for in an academic institution has so many people caring for them from the medical student to the resident. All are interested in their care. And because academic physicians are publishing and giving talks to symposia and at international meetings, they have to be familiar with the latest developments and advances. We can also provide research protocols for the investigation of new drugs and technologies so that the patient can have the opportunity to get access to novel treatments that wouldn’t otherwise be available to them. There is no way the patient cannot benefit from this knowledge base.”
Patients and families appreciate the convenient location of Dr. Helms’ practice. “We are based out of The Saint Louis University Cancer Center adjacent to Saint Louis University Hospital. This allows patients access to all the multidisciplinary facilities and expertise that a cancer patient could possibly need. Physicians with expertise of areas of cancer that are necessary in imaging, nutrition, chemotherapy, research funding and patient educational support are all available in a single location.”
Dr. Helm concludes, “We have three highly experienced gynecologic cancer specialists with a shared commitment to patients. We are also committed to research to develop better treatments for our patients and we are committed to the training and education of the doctors of the future. To balance both the art and the science of women’s healthcare is what it means to me to be a good physician and it is what we strive for every day.”
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