Dr. Daryl Marx, a New Orleans-born Louisianan, comes from a family of physicians. His father, uncle and grandfather all practiced medicine in Louisiana. When Marx was in the in the Boy Scouts, the adage “Leave it better than you found it” resonated with him.
“That is so applicable in medicine,” Marx said. “You want to leave people better than you found them.”
During his high school and college years, Marx worked at a hospital in Monroe. He started his career in medicine as an orderly — mopping floors, picking patients up, answering phones and helping nurses with schedules. He received his medical degree, surgical internship and residency from LSU Health New Orleans School of Medicine.
Now, Marx offers minimally invasive surgery using the Da Vinci Robotic Surgical System. He has performed almost 5,000 robotics procedures during his career and is considered one of the top robotics surgeons in the South based on Da Vinci surgical statistics.
Marx joined Our Lady of the Lake in Baton Rouge in March 2022 as the head of its new Robotics Surgery Institute. The Lake provides robotic, minimally invasive surgeries for general surgeries as well as urology; ear, nose and throat surgeries; and more.
Dr. Daryl Marx headshot (June 2024).
Can you tell us about your path to robotics surgery?
I'm 55, and there were no robots when I was in school. There was laparoscopy — a video camera surgery where you make some small holes to put instruments in. But think about the 1980s and the TVs that we watched back then. There was no high-definition technology.
As I came through my residency, there was some interest in more advanced work. I snuck out of the of the hospital and went to Tulane to watch Carl LeBlanc teach a very early course. I realized that there was a lot more to minimally invasive surgery than met the eye. That's when I decided that this was the way surgery was supposed to be performed.
In the early 2000s, I ran into a brick wall with the instruments that were available. It became very laborious to have technology assistants that weren't always the same in the operating room.
To perform a laparoscopic operation — different from robotics — another human being with another brain is there, and a different pair of hands has to run the camera for a surgeon to see. It's very difficult to communicate.
In 2011, I was exposed to the Da Vinci robotic system as it applied to general surgery. It was like giving a NASCAR to Dale Earnhardt.
I felt like it was built for me and my brain. It was love at first sight.
How has the technology improved as you have worked with robotics?
We now have new features that can put on a sealing device, like a food saver would seal plastic. It seals blood vessels, and we can cut between the seals so nothing ever bleeds.
There's a technology called Firefly where we can inject green dye into the veins that fluoresces, or glows, under UV light. That way we can visualize blood vessels and blood flow to certain tissue real time.
The newer machine has even more bells and whistles on it. Now we have a simulator where we can train new doctors on the machine, as well as older doctors on a simulator. It is very similar to how you would train pilots for flying a plane.
We can teach the junior doctors as they're training in their residency to become very proficient at robotics before they ever have a live patient.
What's next for robotics surgery?
The computing power of the latest robot is 100,000 times that of the Da Vinci XI machine, which launched about the same time as the iPhone. They amped that up so we can integrate AI into the robot. That hasn't come yet, but that's on the way.
It has integrated something called haptic feedback. When we operate with the Da Vinci robotic system, or any robotic system, we have to feel with our eyes. We have to see tension. We cannot feel anything with the machine.
It's like a backhoe. If you're digging a hole and you're digging in the water, you can't feel what the scoop feels. The new machine has haptic feedback, which gives us a sensation of tension on tissues, which is very helpful moving forward.
Why is it important to use robotic technology for surgery?
As a surgeon, think of me like a chef. If you could imagine saying, “You have to cook a gourmet meal for the heads of state, and if you don't do it right, they can take your ability to work away.”
Say you have to do that, but you have to do it in eight different kitchens across town, and they are all stocked differently. The people who help are different. Spices aren't the same. You don't know what's in the cupboard. Maybe they have what you want, maybe they don't.
That's what doing surgery in different hospitals in any given city is like, even sometimes within the same hospital system.
With the Da Vinci system, I can work in Monroe. I can work in Shreveport. I can work in Dallas. I can work in Zimbabwe. If they have a Da Vinci robot, the machine is the same. The instruments are the same. I run the camera, and I don't need a lot of help. It has standardized everything.
It is also so technically precise. It takes all of the human tremor out of your motion. We're human. We're people. This filters that out, so you are absolutely reproducible.
Make no mistake, the robot doesn't do anything by itself. It is not a "hit play and walk out of the room." It doesn't drive itself around the track. It requires a skilled driver — and the robot is only as good as the person driving it.
That said, if you can drive it properly, it's amazing work for performing complicated operations through small holes with extreme dexterity. I personally have taken the skin off of a grape and sewn it back on with a suture smaller than a hair.
Dr. Daryl Marx and his 250-gallon Texas-style, offset smoker that he uses to barbecue for family, friends, events and homeless shelters.
I've heard that you're a bit of a barbecue enthusiast. What do you do in your free time outside of work?
My latest obsession is smoking meat. Not just simple stuff, but really complicated cooks and small catering events. I have a 250-gallon offset smoker that I've really gotten involved in — a real sort of Texas style.
Cooking is a lot like surgery. When you prepare a meal for somebody, you're showing a part of yourself. In that respect, it's very fulfilling, and it's challenging.
I like fire — back to my Boy Scout days. It's fun to sit out by the pit and watch the fire. It's a very nurturing experience with the fire, getting it to perform the way you want and control temperatures perfectly as you tenderize and flavor meat at a grand scale.
And it's great to eat. I may put four racks of ribs and a brisket on, so I need a crew to come have it.
This interview has been edited for length and clarity.