And while the hand controls and video display may remind them of games they may have played, Dexter is way beyond anything they have seen on their X-Box systems at home.

Hospital stay, post-surgery pain and risk of infection are all reduced, with four dime-size surgical ports rather than an 8- to 10-inch incision site. The precision of Dexter also gives a surgeon the ability to avoid nerve areas, saving patients from things like incontinence and sexual dysfunction. Placed in service this past May, the DaVinci S has the ability to reposition itself on command. It is only one of three such systems in the state of Ohio, and it is the first in the Dayton area.

Robotic surgery nurse Sandy Fraysier, RN, explained the benefits of Dexter to the students at the Friday morning session with Fairmont High School biotechnology students. "The kids were very excited about this and asked a bunch of good questions," she said.

Safwat Zaki, MD, did a demonstration and answered questions to a session of anatomy and physiology students Friday afternoon. Dr. Zaki has used robotic surgery systems dozens of times for prostate removal.

Attendees at each of the two sessions saw actual footage from a prostate surgery at Kettering Medical Center, and they also got a chance to work a demo unit which was identical to the DaVinci S now used in a KMC operating room. It was a rare opportunity to test drive a $1.5 million piece of machinery, as they students made sutures on artificial skin and manipulated rings onto colorful stoppers.

"I'm interested in doing forensics . . . like CSI-type stuff," said Paul Cupp, a senior. "After this, though, I might try to get into surgery. It was just a different experience to be able to use something so precise.

"The robot was had to work at first, but once you figure out how close everything is (with the magnification) it gets a lot easier," said Chelsea Crager, 17, who plans to go into veterinary medicine. "It seems like it would be so much easier to get around things you don't want to mess with if you are using the robot."

"The main advantage is instead of having the big 8-10 inch incision with traditional prostate resection surgery, you have small incisions you can usually close with surgical tape," Dr. Zaki said. "Pain is less and hospital stay is much quicker. . . about two days or less on average as opposed to five. The catheter stays in much less time - about a week vs. at least two weeks with traditional surgery. There is a lower chance of incontinence and less chance of impotence - the two big complications you see from prostatectomy. There is also a better chance of total removal of the cancer with less chance of it coming back."

Dr. Zaki was glad to finally meet Dexter, as several of his patients requested robotic surgery after hearing about it through the media. He was the tri-state area's first surgeon to perform a prostatectomy with the use of laproscope four years ago, and the doctor is thrilled to now have the added benefit of the "Da Vinci S" for the good of his patients.

Dr. Zaki added that all potential patients should welcome the use of the new robotic system. Before joining the KMC staff, Dr. Zaki had two years experience with the first generation of robotic systems while at the University of Cincinnati Medical Center.

"It's a misconception that a robot will do the surgery. It allows the surgeon to perform a more delicate, accurate procedure using the benefit of technology," Dr. Zaki said. "The robot has 15 times magnification over the human eye and is much more delicate than the human hand, and it can reach areas where the human hand can't reach. The hand of the robot can also do things the human wrists cannot do."

robotic procedures at KMC on May 2 and 3. Dr. Zaki was seated at the control console, operating the robotic arms from several yards away. Dr. Kalvakota scrubbed in and used laproscopic instruments to help change the instrument heads on the arms while they were still inside the patients.

"There is a lot of communication between the team and the doctor at the monitor," said Lauren Hatton, RN, Coordinator of Robotic Surgery for KMC. "The scrub tech, the first assist nurse, the circulating nurse and the assisting doctor - all of us worked as a team and made it successful. It was such a trill to see it in action for the first time."

Prostate removal is the first application for Dexter, but Rick Mace, Vice President for Clinical Services at KMC, assures that it won't be the last.

"Kettering Medical Center has been on the leading edge of technology from the very beginning. . . from PET scan, to bloodless brain surgery with Gamma Knife, to tools that allow a surgeon to view data in his field of vision the way a fighter pilot does," Mace said. "Dexter is an extension of that, and we have only begun to scratch the surface of applications for robotic surgery. Soon surgeons at KMC will be using this device to assist in kidney, bladder and cardiac surgeries. It will have a dramatic impact on our patients, decreasing their pain, recovery time and potential complications."

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