In mid-September, Kaunas Clinics performed its first operations using the da Vinci robotic surgical system, which the hospital became the first in the Baltic states to install in July this year. The first procedures mark a new stage in the development of robotic surgery at Kaunas Clinics, with the technology set to be introduced across several surgical specialties while specialists develop their expertise and research activities and patient outcomes are evaluated.
According to Kaunas Clinics General Director Prof. habil. dr. Renaldas Jurkevičius, the first procedures using the da Vinci system mark an important step in the development of robotic surgery at the hospital and reflect its broader commitment to technological innovation.
“The first operations with the da Vinci system are another important step in the development of robotic surgery at Kaunas Clinics. However, we are looking much further ahead. Robotisation, artificial intelligence and other advanced technologies are increasingly transforming modern medicine. We therefore aim to be among the university hospitals that not only implement these technologies, but also actively test them, evaluate the benefits they provide to patients and contribute to their further development. The da Vinci robotic surgical system is one step in this direction, and in the future we hope to see more and more such technologies at Kaunas Clinics,” says Prof. habil. dr. R. Jurkevičius.
The surgeon’s movements are precisely replicated by the robotic system
During robotic surgery, the procedure is performed by a surgeon, while the da Vinci system serves as a highly precise instrument controlled by the doctor. Working from a specialised console, the surgeon views the operating field through a high-resolution, three-dimensional image and controls the robotic instruments. The system does not perform surgical actions or make decisions independently; the entire procedure remains under the surgeon’s control.
“The technology enables extremely precise transfer of the surgeon’s hand movements to the operating field, while the design of the instruments allows for precise work in anatomically complex and confined spaces. This gives the surgeon better visualisation of the operating field, highly accurate instrument movements and more ergonomic working conditions,” explains Prof. Evaldas Padervinskis, Head of the Inpatient Services Coordination Service at Kaunas Clinics.
Kaunas Clinics had been preparing for the new phase of robotic surgery long before the first operation was performed. Since July, 16 surgeons working in eight multidisciplinary teams, together with up to 10 other operating-room specialists, have been preparing to use the new system. Training has been conducted, infrastructure adapted and new workflows and patient-safety procedures developed.
“The first robotic operation does not begin in the operating room. Preparation involves more than learning to operate new technology — the entire team must be ready and the whole process must be streamlined. From the beginning, our goal was not simply to perform the first operation, but to create a robotic-surgery ecosystem in which different surgical specialties can consistently develop their own robotic programmes,” emphasises Prof. E. Padervinskis.
New option for treating prostate cancer
The Urology Clinic at Kaunas Clinics has begun using the da Vinci system to treat prostate cancer. The first radical prostatectomy, in which the prostate affected by cancer is removed, has already been performed.
The first operation using the da Vinci system at Kaunas Clinics was performed by urologist Assoc. Prof. Dr. Povilas Aniulis together with Prof. Dr. Mindaugas Jievaltas, Head of the Urology Clinic.
According to Prof. Dr. M. Jievaltas, Kaunas Clinics offers a comprehensive range of modern diagnostic and treatment options for prostate cancer, including magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET) using prostate-specific membrane antigen (PSMA) and other diagnostic tests and biopsies. Treatment is selected individually after diagnosis and may include surgery, radiotherapy or active surveillance. The da Vinci system adds another surgical option.
“First and foremost, we are talking about the patient and the quality of treatment. The new robotic system allows the surgeon to work with greater precision and comfort. Reduced tissue trauma may contribute to an easier postoperative recovery and a shorter hospital stay. At the same time, the technology may allow surgical treatment to be organised more efficiently and enable more patients to receive surgery, while strengthening the role of Kaunas Clinics as a centre for radical prostate cancer treatment,” says Prof. Dr. M. Jievaltas.
“During radical prostatectomy, we work in a very confined pelvic space, where millimetres can be extremely important. Thanks to the da Vinci system, the instruments effectively become an extension of the surgeon’s fingers inside the patient’s body, allowing us to reach and operate on difficult-to-access anatomical structures with high precision. This is particularly important when removing the prostate and tumour while preserving nearby structures that are important for function,” says Assoc. Prof. Dr. P. Aniulis, who performed the first procedure at Kaunas Clinics.
Surgical treatment of prostate cancer is the first area in which the Urology Clinic is using robotic surgery. As the team gains experience, the da Vinci system is expected to be used for kidney and bladder cancer and other areas of urological oncology.
Da Vinci system expands into abdominal surgery
The Surgery Clinic at Kaunas Clinics has also begun using the da Vinci system for colorectal surgery. The first colon cancer operations using the new system have been performed by Assoc. Prof. Dr. Henrikas Paužas, Head of the Department of Colorectal Surgery, and abdominal surgeon Dr. Justas Žilinskas.
“The new da Vinci system does not replace laparoscopic or open surgery. It is an additional method that allows the most appropriate surgical approach to be selected for each patient. All these approaches have their own indications and remain important in modern surgery. We will expand robotic surgery using da Vinci technology not simply where it can be used, but where it can provide the greatest benefit to patients,” emphasises Prof. Dr. Albertas Daukša, Head of the Surgery Department at Kaunas Clinics.
The use of the da Vinci system will therefore be assessed individually for each patient, taking into account the disease and its complexity, anatomical characteristics, previous surgeries, overall health and potential risks. Treatment outcomes will also be monitored, including complication rates, length of hospital stay, functional and oncological outcomes and patients’ quality of life.
Colorectal surgery is the first area in which the Surgery Clinic is using robotic surgery. As experience grows, the technology is planned to be introduced in oesophageal, liver, pancreatic and bile-duct surgery. “The da Vinci system will be expanded to new areas in stages, after specialist teams have been prepared and clear clinical criteria established,” emphasises Prof. Dr. A. Daukša.
First operations mark the beginning of a wider programme
Following the first procedures, the da Vinci robotic surgery programme at Kaunas Clinics is entering its next phase, with the technology being gradually incorporated into clinical practice across different specialties. Clinical experience will be collected and analysed, treatment outcomes evaluated, and specialist training and research activities further developed.
The robotic surgery programme will expand into new areas in the coming months. In October, teams from gynaecology, upper gastrointestinal surgery, paediatric surgery and otolaryngology will begin working with the da Vinci system. In November, the liver and pancreatic surgery team is scheduled to begin using the system.
