Dr. Abaza’s hands weren’t touching Mr. Murray or the surgical tools he used to perform the five-hour surgery. Instead, the urologist’s hands and feet were inside a console meticulously controlling three robotic arms — two for small scissors, forceps, and other tools, and a third for a camera conveying a three-dimensional image — through a series of incisions in Mr. Murray’s abdomen that were each less than three inches wide.

Those robotic arms and small incisions, Dr. Abaza and other doctors at St. Vincent Mercy Medical Center said yesterday, provide a multitude of benefits over conventional open bladder surgery requiring one long incision down the abdomen.

Mr. Murray, 66, lost just three ounces of blood, will have less chance of infection, and should recover in days instead of weeks, while Dr. Abaza got an unobstructed view into his pelvis area and was able to make precise surgical movements.

And using St. Vincent’s $1.5 million da Vinci robot system for bladder cancer represents the last urological hurdle on Dr. Abaza’s list. The 33-year-old Toledo native performed the first bladder cancer surgery at St. Vincent two weeks ago, and yesterday he shaved two hours from that successful endeavor’s time, which was at least an hour less than most conventional attempts, he said.

“This is really the most complex robotic surgery that’s done today,” said Dr. Abaza, medical director of the Laparoscopy Simulation & Robotics Training Center at St. Vincent, where area doctors are learning how to use the technology. “Every open operation we do now, I’m doing robotically.”

St. Vincent installed the Toledo area’s only robotic surgery system four years ago, and it had been used for prostate, benign kidney, and prostate surgeries. After being trained at Henry Ford Hospital in Detroit and coming to St. Vincent a year ago, Dr. Abaza has extended the robotic equipment’s use to seven additional procedures on five organs.

“We’re really, really trying to push the limits as much as we can,” he said. “So far, I haven’t found any limits.”

Mr. Murray said Dr. Abaza out-lined three treatment options for the bladder cancer his doctor diagnosed in mid-June, and having minimally invasive surgery, with less pain and complications, to battle the disease was the undisputed choice.

Most surgeries eventually will be done robotically, the Toledo man predicted.

“Dr. Abaza explained it really well,” Mr. Murray said shortly before his successful surgery began. “I’ve been to doctors before where you don’t know what the heck they said.”

Mr. Murray had six incisions, three for the robotic arms controlled by Dr. Abaza. From the console where Dr. Abaza sat, the urologist used his hands and feet to move the robot’s arms positioned over Mr. Murray.

People assisting Dr. Abaza during surgery, six-year urology residents Drs. Saleem Zafar and Jon Picard as well as surgical technologist Amy Katona, flanked Mr. Murray and used the three other incisions to insert additional surgical instruments as needed. They watched magnified two-dimensional images from the camera controlled by Dr. Abaza on nearby screens.

“As you can see, assistants are really valuable for the procedure,” Dr. Abaza told The Blade during Mr. Murray’s surgery yesterday.

Dr. Zafar, who next year will join Dr. Abaza and his partner, Dr. Mirza Baig, said the ability to precisely make cuts and other maneuvers during robotic surgery is incomparable.

Added third-year urology resident Dr. Fadel Elkhairi of the camera’s reach into Mr. Murray’s pelvis area: “This is a view you will never, ever get in open surgery.”

Reprinted with permission of The Blade, Aug. 14, 2007.