Dr. Christopher J. Kane is a specialist in prostate cancer and an expert in robotic and other minimally invasive procedures for urologic surgery.
Named a 2013 “Top Doc" in San Diego Magazine’s “Physicians of Exceptional Excellence" annual survey performed in collaboration with the San Diego County Medical Society, Dr. Kane is internationally recognized for his patient care and research in prostate cancer, renal cell carcinoma, and minimally invasive surgical treatment of urologic diseases and disorders.
Dr. Kane is an expert in robotic prostatectomy, open and laparoscopic kidney cancer surgery and bladder and testes cancer surgery. He has authored more than 220 publications and book chapters primarily on prostate cancer risk factors and outcomes, prostate cancer surgery and minimally invasive surgery for prostate and kidney cancer. He has taught laparoscopy and robotic surgery extensively and started the robotic surgery program at UC San Francisco and at the VA Medical Center San Francisco in 2002.
He performs over 200 robotic cancer surgeries per year and is highly experienced in nerve sparing robotic prostatectomies, robotic radical cystectomy for bladder cancer and robotic partial nephrectomy for kidney cancer.
To make an appointment with Dr. Kane, please call: 858-822-6187
Conditions and Treatments
Consultation for Robotic Surgery
In this hypothetical conversation between patient and doctor, we present an example case in which a patient is scheduled to have a laparoscopic gall bladder removal (cholecystectomy) and her doctor is considering using a robot in the surgery. In this discussion, the doctor describes the way the robot works, the reasons for using the robot, and the advantages of robot-assisted laparoscopic surgery in comparison to the standard laparoscopic approach.
This consultation is presented for purposes of general information. Please see your surgeon to discuss your individual case
Doctor: Hello. How are you today?
Patient: I am fine.
Doctor: I understand you are here to ask some questions about robotic surgery.
Patient: Yes. I am going to have my gall bladder removed at Thornton Hospital, and my doctor told me that he may use a robot during my surgery.
Doctor: Yes. Here at the University of California, San Diego, Thornton Hospital, we are fortunate to have a DaVinci™ Surgical System. This is a cutting-edge technology and it is commonly referred to as “the robot.”
Patient: This is a new development in surgery, isn’t it?
Doctor: Yes. The robot was approved by the Food and Drug Administration (FDA) in July of 2000 for use in general laparoscopic surgery.
Patient: What is the surgical robot, exactly?
Doctor: It is a set of equipment in the operating room, including robotic arms, a computer, and a console that provides all the controls for the surgeon to micro-manipulate the robot.
Patient: And you use robots to do the kind of procedure I am going to have?
Doctor: Yes. Your surgery is one of the procedures we can now perform with the robot. We can also use this device to perform laparoscopic Nissen fundoplication (an anti-reflux procedure), laparoscopic Heller myotomies (for achalasia), laparoscopic colon resections, and laparoscopic paraesophageal hernia repairs (for hiatal hernias).
Patient: How does the robot work?
Doctor: The robotic surgeon consists of two main components: bedside robotic arms and an operating console. For robot-assisted laparoscopic procedures, the surgeon makes tiny incisions in a patient’s abdomen and inserts the long and thin robotic instrument arms and a camera inside. The surgeon then takes her position at the operating console, which is usually about 10 feet away from the patient, but still in the operating room, while an assistant remains at the operating table.
Patient: How much of my operation does the robot actually do? Does it move on its own?
Doctor: No. The surgeon sits at the operating console and controls every move that the bedside robot makes. The robot only copies the movements made by the surgeon, it does not move independently.
Patient: How does the surgeon see what he is doing if he is so far away?
Doctor: The surgeon is able to see what he is doing by looking at a screen in the console that has a picture from the camera inside the patient.
Patient: Why do you use the robot?
Doctor: One of the advantages is that the robot gives the surgeon a much better picture. Any time we do a laparoscopic surgery, we are operating through very small incisions, and we are using a camera to see inside the abdomen as we operate. With standard laparoscopic imaging equipment, the surgeon sees a lower resolution image that is flat and two-dimensional, like the picture you see on a regular television screen. The DaVinci system gives us a high-definition, three-dimensional picture. The better we can see the structures inside the abdomen, the more accurate our surgical movements will be.
Patient: Are there other advantages to using the robot?
Doctor: Yes. Another advantage is that the surgical instruments used by the DaVinci system are capable of more complex maneuvers than are possible with standard laparoscopic instruments.
Patient: What does that mean?
Doctor: When we are using standard laparoscopic instruments, we do not have the full range of motion that a surgeon’s hands have in an open surgical procedure. But the robot has a range of motion similar to that of the human hand, so it is capable of delicate, precise movements that are beyond what is possible in a standard laparoscopic surgery. The instruments are manipulated by the controls at the console and their movements are more precise and less subject to tremulous movement.
Patient: Are there any other advantages?
Doctor: Yes. A computer is integrated into the DaVinci system, and it can motion scale all of the surgeon’s moves at the console. This means that larger moves at the console are exactly replicated, but on a much smaller scale, by the bedside robot. This is another factor that makes very fine and precise movements during surgery possible.
Patient: Is it best to use the robot in my surgery?
Doctor: The robot is not appropriate for use in every patient or during every laparoscopic procedure. Many procedures are more easily and quickly performed without the use of the robot. Your surgeon will tell you if he thinks the robot should be used in your procedure.