Dr. Scott Rushing takes off his shoes and sits down at the console before beginning surgery.
He’s a few feet from his patient and won’t even look in her general direction for the radical hysterectomy and staging procedure for cervical cancer he’s about to perform at PeaceHealth Southwest Medical Center in Vancouver. That’s because with the help of a da Vinci robot, Rushing will utilize a camera, viewfinder, foot pedals and actuators to control robot arms and instruments to complete the surgery.
Hundreds of thousands of robotic surgeries are performed around the world each year. So Rushing isn’t in special company there. Where Rushing stands out is in his early adoption of the technology, back in 2007, leading him down the path to completing his 1,000th robotic surgery last week.
Rushing, a gynecologic oncologist with Compass Oncology and the medical director of PeaceHealth Southwest’s GYN/oncology services, is one of the three or four active surgeons in his specific field in this region to reach that number, said Jeff Gillam, an executive sales representative with da Vinci.
“He’s one of a handful of guys in the Pacific Northwest in this company,” said Gillam, who was on hand for Wednesday’s surgery.
Rushing’s journey to robotic surgery began at a conference in San Diego. He saw a demonstration of the da Vinci Standard, and on his way back from the conference, in a taxi headed to the airport, he called the hospital’s CEO, Joe Kortum, and said they needed to acquire a robot.
“I just realized this is going to be a game-changer for my patients,” Rushing said. “This is totally going to allow me to do a better cancer surgery. It’s going to allow them to have a better recovery, better outcomes.”
It would be a couple of years before Southwest got a da Vinci, but Rushing started training immediately. Since there were no gynecologists in the area using robotic surgery techniques at the time, he learned under a urologist in Portland.
“I started operating on men with prostate cancer, which is kind of funny as a gynecologist,” Rushing joked.
Once he was trained, Rushing started taking patients in Portland, completing his first robot surgery in 2007. He did his first 50 or so robotic surgeries in Portland and the rest in Clark County — he’s probably completed close to 4,000 total surgeries in his career.
The first robotic surgery he led was on a patient with cervical cancer. Rushing said the woman was brave, and he commended patients who aren’t afraid to test new medical advancements. She was taking a risk, but it’s something that paid off for the 999 patients who followed her, he acknowledged.
“It’s easier to do the 1,000th surgery than the first,” Rushing said.
It took Rushing about six hours to complete robotic surgeries when he began. His 1,000th surgery was completed in less than 30 minutes. He said that the first 50 or so cases had a steep learning curve, but after that, things began to feel more natural. Rushing compares controlling the robot to learning to drive a car with a stick-shift transmission.
“There’s a lot of moving parts when I’m at that console,” he said. “There comes a point in time where I don’t have to think about what I’m doing. It’s all second nature.”
At his console, Rushing looks into a viewfinder that is similar to binoculars. It gives him a 3D view.
“It feels like you’re inside the patient’s body,” Gillam said.
The robot has four arms, one of which is the camera. Gillam said it’s similar to giving a surgeon an extra arm. He controls the robot with foot pedals and actuators, which are like joysticks. Rushing is currently using the da Vinci Xi. The first robot Rushing used, the da Vinci Standard, is now on display at a Smithsonian museum in Washington, D.C. He recently saw it while visiting the nation’s capital.
Patients are sometimes skeptical of robotic surgery, but for the most part that skepticism has lessened with time. Sometimes patients have thought robotic surgery means Rushing is just going to press a button and let the machine do the work. But it’s something he fully controls.
“If I don’t move my fingers a millimeter, the robot doesn’t move a millimeter,” he explained. “It’s not something that works autonomously. It’s something I control completely.”
At the conclusion of Rushing’s 1,000th surgery, he slipped on his shoes and stood back up.
“All right, we’re done,” he said.
Next Rushing updated a family member of the patient. Then he took a picture with five other surgery team members under a banner that read: “Congratulations Dr. Rushing on completing 1000 robotic cases!!” They went to a break room for a celebration, where, after completing 1,000 robotic surgeries, Rushing ended his work day with a first: eating cake.