Paragon Surgical Specialists – Dr. Brian Schmidt and Robotic Surgery

MedSoup 0:04
 Welcome to the MedSoup podcast, where we talk about trending healthcare topics. I’m your host, Laura Schumacher, let’s dig in.

MedSoup 0:17
Today we are here with Brian Schmidt of Paragon Surgical Specialists in Concord, North Carolina and we are going to be discussing robotic surgery. Thanks for being with us.

Dr. Brian Schmidt 0:28
Thanks for having me.

MedSoup 0:30
So, can you tell us a little bit about your background with Paragon Surgical?

Dr. Brian Schmidt 0:34
Sure, I’ve been with Paragon Surgical Specialists for about 15 years now, came here straight from my training at the Mayo Clinic. And, I’ve been doing robotic surgery for probably the last six years now.

MedSoup 0:48
So, that requires some additional training and certification doesn’t it?

Dr. Brian Schmidt 0:53
Correct, robotic surgery is traditionally different from hospital to hospital. Most hospitals have a formal credential process where you have to do extra training, both the hands-on training and the labs. Also, proctored cases where you have other surgeons helping you as you’re first starting out.

MedSoup 1:14
Are there particular types of conditions that are better suited for robotic surgery?

Dr. Brian Schmidt 1:20
Robotics is an ever-evolving field, now there’s very many indications that were not present five years ago. We do a fair amount of hernia surgery including Hiatal hernias, incisional hernias, inguinal hernias. Also, a lot of colon surgeries are now done robotically. There’s a lot of centers as well that are doing more complex surgery, such as lung surgery are now being done robotically. 

MedSoup 1:52
So in terms of the number of surgeries that you’re doing, what’s the percentage that would be done as an open surgery versus minimally invasive.

Dr. Brian Schmidt 2:02
The type of repairs are really patient dependent but on average, hernia repair, 100% of my hiatal hernia repairs are done robotically. Probably about 50% of my inguinal hernias are done robotically.

MedSoup 2:21
So the recovery is easier for the patient that way?

Dr. Brian Schmidt 2:25
Recovery tends to be easier and I’ve found that is seems to surpass laparoscopic surgery. There tends to be less pain, just due to the technique and how we do the surgery and fixate mesh and so forth.

MedSoup 2:40
What’s the difference between robotic and laparoscopic? 

Dr. Brian Schmidt 2:43
With laparoscopic procedures, typically you have to use tackers to fixate mesh, especially with inguinal hernias and ventral hernia. With Robotic surgery, due to the mobility and instrumentation, we are able to sew the mesh in so it’s less traumatic to the tissues.

MedSoup 3:02
So the patient pictures this big robot doing the surgery but actually it’s actually very tactile. Can you explain what a patient would see?

Dr. Brian Schmidt 3:15
Sure, and that’s a very common misconception that the robot is doing the srufgery. The robot is actually a very advanced, fancy piece of equipment that we use to do the surgery. So the surgeon is still in control of everything in performing the procedure. The robot is just a fancy instrument that we use.

MedSoup 3:33
So you’re right there in the room?

Dr. Brian Schmidt 3:35
Correct, we are right next to the patient.

MedSoup 3:37
Are there any risks that anyone should be aware of with this particular type of surgery?

Dr. Brian Schmidt 3:42
No specific risks to the robotic surgery, outside of what there is for any type of open or laparoscopic type of procedure.

MedSoup 3:51
Will there ever be a case where someone would not want to have this as opposed to an open or procedure.

Dr. Brian Schmidt 3:56
Sure, there’s some contraindications to some robotic surgery. You know, specifically for certain hernias. Previously prepared neo-repairs sometimes, people who had had procedures destroy the tissue planes that you need to do the robotic surgery. So there are certain indications that a patient is better treated with an open repair than a robotic repair.

MedSoup 4:22
So, if someone wanted to understand a little bit more about this, they can visit the website at https://paragonsurg.com/ and there are also some videos available that actually details the procedure and they can understand it a little bit better?

Dr. Brian Schmidt 4:37
Correct, and intuitive surgery makes the robotic platforms, they also have videos on their websites that explain a lot of that.

MedSoup 4:45
Okay, well great. Thank you so much.

Dr. Brian Schmidt 4:47
Thank you.