Hilo Medical Center recently acquired new high-tech surgery equipment and a specialist who knows how to use it.
HMC received a robot — also known as a da Vinci Surgical System — last October and is leasing it for $400,000 per year. The four-armed robot helps doctors perform minimally invasive surgeries.
Instead of making a large incision with handheld tools, surgeons use the robot to take a less invasive approach requiring just a few small cuts.
“Using a robot is the up-and-coming thing as far as surgery goes,” said Monica Gomes Figueira, nursing supervisor for surgery. “It is less invasive with less pain in recovery. It makes small cuts, and it only moves what needs to be moved. It’s less, so it’s more.”
According to Gomes Figueira, robotics has become the standard of care for a number of procedures and is in wide use on Oahu, Maui and across the country.
To date, the robot at HMC has assisted surgeons in performing a total abdominal hysterectomy, hernia repairs and cholecystectomies.
HMC employs five surgeons trained in robotics. Two are highly trained, and three have just started their robotics journey.
Physicians start their training with didactics over the computer, then they learn about the robot with a trained surgeon at a hospital.
After those first steps, they begin practicing at the hospital where they need to achieve a certain amount of hours using the robot before going to a da Vinci site to work on cadavers for two weeks.
Doctors then then perform surgeries with a proctor for about 50 procedures. Training takes about five months in total, according to Gomes Figueira.
HMC recently brought in expert gynecologist Janine Doneza to start a program that would offer minimally invasive gynecologic surgeries on the Big Island.
Doneza, originally from Ewa Beach, is a board-certified, fellowship-trained laparoscopic and robotic surgeon.
Doneza received her medical education at the University of Hawaii John A. Burns School of Medicine. After graduating, she attended residency in obstetrics and gynecology at the NYU Langone Hospital for three years.
After her residency, she spent two years in a fellowship for minimally invasive gynecologic surgery at the Icahn School of Medicine at Mount Sinai in New York.
“When I started med school, I knew I wanted to do something with my hands in the operating room,” Doneza said. “I initially started with general surgery, but decided that lifestyle wasn’t compatible for what I envisioned for myself.”
After meeting Dr. Jason Wright, one of the biggest names in gynecology, Doneza decided to pursue gynecologic surgery and women’s health.
“My first experience doing women’s health was in Mexico, where we were bringing surgical procedures to a really remote area,” Doneza said. “It was amazing to have that connection with patients, and as a woman in this field, it’s deeper than that.”
The experience in Mexico fueled her passion to help underserved people.
“I’m passionate about working with a diverse group of underserved patients,” Doneza said. “I want to work with patients that have been neglected the most. I mean, the people I grew up with — many of them never got care, either.”
Doneza later worked in Bronx in New York City at a poor, inner-city hospital. After some time, she became the director of the Robotics Program and Fibroid Center, where she offered minimally invasive gynecological surgeries to her patients.
“The cases I saw from women basically broke every record I’ve ever had as far as size, number and complexity,” Doneza said. “People who came in after surgeries were so appreciative. I miss them the most, but that is what I’m looking for again.”
After a great experience in New York City, Doneza was ready to come home to serve the community she grew up with.
While she is originally from Oahu, Doneza wanted to come to Hilo, where there are less resident surgeons, so she could create a gynecological program completely on her own.
“When you come to Hawaii, the truth is a majority of surgeons are male and on Oahu. If I went back to where I’m from, I would always be under the shadow of a male counterpart,” Doneza said. “I can’t stand when someone tells me how a male surgeon does something differently. I wanted to come here and develop a program on my own just like I did in New York.”
Doneza sees HMC as a perfect hospital to start a program since there are many patients that could benefit from care done on island instead of on Oahu.
“I think a large proportion of patients are underserved. There are many women of different ages that have issues that haven’t been addressed for many reasons,” Doneza said. “Developing a program here means better care and better delivery of care. You don’t have to travel to Oahu, which is what patients need and want.”
Even though Doneza was content with her career in New York, she was excited to come home and finally bring her family with her.
“Seeing my 18-month old roll around in the grass just brings me so much joy,” Doneza said. “We didn’t have grass in New York, and now he’s walking around barefoot like he was born here.”
Doneza hopes to reach more people of all walks of life on the Big Island as she grows the robotics and gynecological surgery program at HMC.
“I want to make something bigger for the island while reaching the whole spectrum of women,” Doneza said. “Sometimes I think about the hard work coming up, but there is no alternative. I want my family to be together. I want to stay and make this work.”
Doneza is currently accepting new patients for gynecological conditions at the East Hawaii Health Clinic. She is not available for obstetrics, which involves all aspects of pregnancy.
Along with minimally invasive gynecological surgeries, Doneza specializes in treatment of uterine fibroids, heavy bleeding and endometriosis. She also provides a full range of in-office gynecological care.
Last Monday, Doneza facilitated her first robotic surgery in Hilo with a minimally invasive hysterectomy.
The case went very well, according to Doneza.
Due to the small incisions that were made, the operation and post-operative care was shorter than the inpatient stay.
“This is very exciting because this case could have easily been sent to Oahu,” Doneza said. “This is care that was provided here, and now the patient can go home to their dogs in less than 24 hours.”
Email Kelsey Walling at kwalling@hawaiitribune-herald.com
