THE doctor sits in a darkened corner of an operating room about 10 feet from where his patient lies on a gurney. Members of his surgical team stand around the room's periphery, staring at several large, flat-screen video monitors hanging from the ceiling.
On screen is a colon, shiny and pink. The patient himself is barely visible, shrouded in surgical sheets and dwarfed by a refrigerator-sized, four-armed robot positioned over his body.
He almost appears to be alone, even adrift, with a team of physicians and nurses trying to reach him from afar.
In reality, surgeon Alessio Pigazzi and his team at City of Hope are getting the best possible view and access. The robot's arms hold slender surgical instruments, a tiny camera and a light, all threaded through dime-sized openings in the abdomen. The monitors reveal a bright, nearly bloodless landscape, magnified 10 times.
Using hand controls and foot pedals, Pigazzi commands the robot from a console, sliding the instruments into the tight confines of the rectum where a cancerous tumor sits -- a space nearly impossible to see without the technology at his disposal. "There it is," he announces.
This is 21st century surgery -- with little blood loss, rapid healing and minimal scarring -- and it's quickly replacing surgery in which scalpels (in, hopefully, steady hands) slice long, bloody incisions through the body. In this dynamic movement, doctors aim to fix the body without hurting it.
"People will soon look back at any large incision as barbaric and archaic," says Dr. Paul A. Wetter, chairman of the Society of Laparoendoscopic Surgeons and a professor emeritus of gynecology at the University of Miami.
In only the last few years, minimally invasive surgery has evolved from a popular technique used for the simplest of abdominal surgeries -- such as a gallbladder removal or hernia repair -- to a method that can treat even life-threatening diseases such as cancer, heart problems and emphysema.
An increasing number of these surgeries are augmented with sophisticated computer and imaging technology -- such as robots. Such techniques elevate ordinary doctor skills to the super-human level by providing magnified, high-definition images and by preventing mistakes, such as cutting into the wrong tissue.
Some doctors are even taking the first tentative steps toward operating without incisions, using the body's natural openings -- the nose, mouth and anus -- to gain access to its inner workings.
