Riding Robotic Surgery’s Third Wave: T. Sloane Guy MD, MBA, Presents at TEDxFairfieldUniversity

On October 28, 2019, the Regina A. Quick Center for the Arts at Fairfield University came alive with creative energy and innovative fervor. In honor of the School of Engineering’s 25th anniversary, CEOs, doctors, authors, and scholars from around the country gathered to share their ideas and participate in TEDxFairfieldUniversity, including T. Sloane Guy, MD, MBA, the director of minimally invasive and robotic cardiac surgery at Jefferson.

In his talk, “Innovation Inspired by Adversity: Robotic Surgery’s Third Wave,” Dr. Guy walked the audience through the development, obstacles, acceptance, and advancements of robotic surgery—a subject with which he has been closely involved for nearly 20 years—since its inception in the early 2000s.

Dr. Guy attended Wake Forest on an ROTC scholarship, where he walked onto the varsity football team as a wide receiver, and graduated magna cum laude and as a distinguished military graduate. He proceeded to receive an MBA from the Wharton School of Business in 1992 and his medical degree from the University of Pennsylvania School of Medicine in 1994. He also spent nine years as an active-duty trauma surgeon, completing two tours in Afghanistan and one in Iraq. Dr. Guy, who is nationally renowned for his work in robotic mitral valve repair and other robotic cardiac surgical procedures, joined Jefferson in 2019, allowing the hospital to offer these procedures for the first time. In addition to his innovative work with robotic surgery, he is trained in an array of cardiothoracic procedures and possesses a broad range of surgical skills.

Having always considered himself a “gadget guy,” he recognized early on the inherent potential of robotic surgery. Through his longtime work in the field, Dr. Guy has experienced firsthand the opposition to robotic surgical procedures from those in the medical field and the challenges that the subspecialty has overcome.

“People often talk of innovation as if it’s this wonderfully beautiful thing that progresses without impediment,” Dr. Guy says. “In fact, innovation is incredibly difficult, and you’re probably not really innovating if you don’t have many people opposed to your efforts.”

The first wave of robotics started in 2000, when the first da Vinci Surgical System was approved by the Food and Drug Administration for general laparoscopic surgery. The original da Vinci robot had just two arms and a camera, and still required a surgical assistant during operation. While this was a pivotal moment for robotic surgery, these procedures were relatively simple and still required fairly large incisions.

Over the following decade, the next major shift was precipitated by the introduction of more advanced robotic systems. For example, da Vinci added a third arm for surgical retraction, and new competitors started gaining interest in the robotic surgery industry. It was during this second wave that robotic surgeons started shifting toward surgeries that were totally endoscopic, which resulted in smaller incisions and quicker recovery times.

The third—and current—wave of robotic surgery is defined by a period of training and education. Now, with a proven track record of success and skeptics falling to the wayside, physicians are focusing on developing new techniques and training the next generation of robotic surgeons.

“It’s really the maturation of the subspecialty,” Dr. Guy says.

Dr. Guy doesn’t see the robotic revolution in healthcare slowing down anytime soon. He has joined onto the Verb Surgical project—a joint effort between Johnson & Johnson and Google—as a consultant to develop a new robotic surgery system that will incorporate artificial intelligence and deep learning. Just as he was an early adopter back in 2001, Dr. Guy intends to stay ahead of the curve as robotic surgery shapes the future of healthcare.

“The life of the innovator is not pain-free,” Dr. Guy says. “And yet we need innovators more than ever, and I try my best to be an inspiration to others.”