Clinical Weight Loss University Of Pennsylvania

Israeli doctors learn robotics, with the help of local MDs

It was called "Star Trek surgery", but California-based Intuitive Surgical makes sophisticated surgical robots for the here and now. And through a program supported by the Jewish Federation of Partnership2Gether northern New Jersey, the Israeli doctors learn to use the most American-made aircraft with the intention to introduce robotic surgery in Israeli hospitals.

"They have sent us doctors to teach us about emergency response and have sent doctors to teach surgery without blood," said Dr. Deane Penn, before describing aspects of the program P2K. This month the program brought two Israeli surgeons to northern New Jersey for the latest initiative, to improve medical practice and technology in Israel by teaching Israeli doctors robotic surgery. Penn and his wife, Susan, hosted a reception and talk in their Alpine home on July 13, where the two sponsored doctors shared their perspectives with members of the community. Penn, a retired gastroenterologist, works as a medical stock analyst, advising hedge funds on medical technology investment strategies. He also runs The Center for Medical Weight Loss in Englewood with his partner, plastic surgeon Dr. Herbert Feinberg.

“Laparoscopic urology is less invasive than regular surgery, but robotic is even less invasive,” said Penn. “With the 3D lighting effect you can see the tissues better and the robot can get into places that human hands cannot. There is less bleeding, and the patient can leave the hospital the next day,” he added.

The four-armed da Vinci robotic apparatus (named for Leonardo da Vinci who drew and designed the first robot) has computer-controlled mechanisms that hold two or three surgical tools as well as an endoscope, i.e., a tiny camera and light.Advanced systems use algorithms to translate the hand movements of surgeons skilled fine movements minimally invasive surgery. As it can be used to remove tumors or tissue repair with minimal damage, robotic surgery is particularly useful in urology and obstetrics. Thus, the two doctors chosen for this first visit was a urologist and an obstetrician.

One of two doctors, Dr. Adi Lazar, 41, was born in Romania and attended medical school there. After residency training in Israel and France, he settled in Israel and is now a senior urologist at Western Galilee hospital in Nahariya.

“Most of the radical prostatectomy in the U.S. is done by robots,” said Lazar. When traditional prostate surgery is performed there is a significant risk of complications such as incontinence and impotence. Lazar explained that with robotic surgery, prostate cancer survival rates are better, with fewer side effects. He estimated that the systems for robotic surgery could cost between $1 million and $2 million.

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This undated file photo provided in May 2009 by The Greenville County Sheriff’s Office shows Jerri Gray, 49, of Travelers Rest, S.C. An article in a prominent medical journal being released Tuesday, July 12, 2011, says that parents of extremely obese children should lose custody for not controlling their kids’ weight in the most extreme cases. Two years ago, Gray lost custody of her 14-year-old son who weighed 555-pounds. She says government authorities don’t understand challenges families may face in trying to control their kids’ weight. Her sister has custody of the boy, who’s now 16. She has the money to help him with a special diet and exercise, and the boy has lost more than 200 pounds. (AP Photo/The Greenville County Sheriff’s Office, File)

(AP) — Should parents of extremely obese children lose custody for not controlling their kids’ weight? A provocative commentary in one of the nation’s most distinguished medical journals argues yes, and its authors are joining a quiet chorus of advocates who say the government should be allowed to intervene in extreme cases.

It has happened a few times in the U.S., and the opinion piece in Wednesday’s Journal of the American Medical Association says putting children temporarily in foster care is in some cases more ethical than obesity surgery.

Dr. David Ludwig, an obesity specialist at Harvard-affiliated Children’s Hospital Boston, said the point isn’t to blame parents, but rather to act in children’s best interest and get them help that for whatever reason their parents can’t provide.

State intervention “ideally will support not just the child but the whole family, with the goal of reuniting child and family as soon as possible. That may require instruction on parenting,” said Ludwig, who wrote the article with Lindsey Murtagh, a lawyer and a researcher at Harvard’s School of Public Health.

“Despite the discomfort posed by state intervention, it may sometimes be necessary to protect a child,” Murtagh said.

But University of Pennsylvania bioethicist Art Caplan said he worries that the debate risks putting too much blame on parents. Obese children are victims of advertising, marketing, peer pressure and bullying – things a parent can’t control, he said.

“If you’re going to change a child’s weight, you’re going to have to change all of them,” Caplan said.

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