May 23, 2018
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Doctor demonstrates robotic surgery at EMMC

By Dawn Gagnon, BDN Staff

BANGOR, Maine — As her 63-year-old patient lay on an operating table across the room from her, Dr. Michelle Toder used what resembled a pair of sophisticated video game controllers to maneuver a robot that served as her eyes and hands.

On Thursday morning, Eastern Maine Medical Center provided a rare look at what goes on behind the scenes during a gastric sleeve procedure, which involves removing most of a patient’s stomach — 85 percent of it, Toder said — with only five small incisions to help the patient lose weight in the future.

Toder, leader of EMMC’s epicenter team, explained why the hospital has been designated as the nation’s first — and only — general and bariatric, or weight loss, surgery robotic epicenter by Intuitive Surgical, the company that made the $1.75 million da Vinci Surgical Systems robot she was using Thursday.

As an epicenter, EMMC has access to the latest in robotics technology instrumentation and provides training to medical professionals throughout the nation in the use of the technique.

The patient who was operated on Thursday morning at EMMC was more than 100 pounds overweight and was suffering a variety of health problems, including a hernia, as a result. The procedure she underwent was called a gastric sleeve gastrectomy, she said.

“She’s done an awful lot of work ahead of time,” Toder said, adding that the patient lost 60 pounds in preparation for Thursday’s operation.

The woman agreed to allow the procedure be photographed and recorded on video so others might learn about the benefits of the minimally invasive procedure.

“She was excited about our sharing the program today,” Toder said as she peered into a small screen giving her a three-dimensional view of the patient’s internal organs.

Before entering the operating room, news reporters and videographers were required to don disposable paper scrubs and bouffant caps, booties and face masks to prevent the spread of germs.

Because of federal patient privacy laws, the hospital did not disclose the patient’s name. Further obscuring her identity were the sterile cloths draped over most of her body. In fact, the only part of her body that was visible was the surgeon’s work space, a space on the patient’s abdomen slightly larger than a sheet of office paper.

“For patients who qualify, the benefits of robotic surgery are remarkable — smaller incisions, faster recovery, less scarring and less pain,” Toder said. Employers also gain in that surgical procedures once kept recuperating patients at home for six to 12 weeks. Because of robotic surgery, many patients now are able to return to work in about two weeks, unless their work or work environment is physically demanding, the doctor said.

The new robotic weight loss procedure is part of EMMC’s Surgical Weight Loss Program, which has existed for more than 30 years, according to the program’s Web page. Besides surgery, the program offers education and a strong support network that Toder noted includes surgeons and other medical professionals like herself.

The program, according to EMMC, is one of the first surgery and weight loss centers in the nation to offer robotically assisted surgical procedures for patients deemed appropriate.

Toder said that when robotic surgical technology arrived at EMMC in 2005, it was primarily used for heart operations. The technology, however, turned out to be much better suited to other kinds of procedures, including general surgery, weight-loss surgery, and urological and gynecological operations, she said.

Toder, who said she has more than 1,000 robotic operations under her belt, has just added a new procedure to her arsenal.

On Wednesday, she was trained in — and will begin using later this month — a new gallbladder removal technique which ensures that patients will have only one small incision in their belly button instead of the four incisions with traditional minimally invasive surgery.

For information about robotic surgery at EMMC, visit For information about the hospital’s Surgical Weight Loss Program, visit

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