Single-Site, Robotic-Assisted Gallbladder Surgery

Is It for You?

Tom Fahey, MD, FACS

Dr. Tom Fahey is the only surgeon in the region trained and experienced in single-site, robotic-assisted gallbladder surgery.

Dr. Tom Fahey Single-Site Robotic-Assisted Gallbladder Surgery

Single-Site Surgery

For patients with gallstones and gallbladder disease, single-site, robotic- assisted surgery may be an excellent option. It is virtually scarless and recovery time is usually much faster than conventional gallbladder surgery. There’s less pain and less bleeding, too.

About Your Gallbladder

Your gallbladder is a pear-shaped organ under your liver that stores and concentrates bile to help digest fat. Gallbladder disease includes inflammation, infection or blockage of the gallbladder. The most common blockage is a gallstone. Gallstones are pebble-like and solid. They can be as large as a golf ball or as small as a grain of sand.

Gallbladder disease is very common, affecting about 10-15 percent of adults in developed countries. It is more common in women, Native Americans, Hispanics, the obese and people over age 40.

Disease Symptoms

Gallbladder disease symptoms may include pain in the upper right side or middle of the abdomen, abdominal fullness, clay-colored stool, fever, nausea and vomiting, or yellowing of skin and whites of eyes.

Disease Treatment

Treatment for gallbladder disease may include lifestyle changes, medicines and procedures. However, when routine medical care does not ease your symptoms, surgery may be needed. Depending on how severe your symptoms are, doctors may need to remove your gallbladder. This operation is known as a cholecystectomy.

Gallbladder surgery is generally performed using manual laparoscopy. This technique uses several small incisions to access the gallbladder. The approach is intended to speed recovery, minimize pain, reduce blood loss and complications, while offering the added benefit of minimal scarring.

Surgeons may also perform laparoscopic surgery through one incision to virtually eliminate scarring. While single-incision manual laparoscopic surgery does minimize scarring, there are limitations for the surgeon, including reduced visibility, restricted instrument control, restricted reach and increased fatigue due to poor ergonomics. Also, some patients may not be candidates for single-incision laparoscopy if they have complex anatomy or adhesions from a prior surgery. Due to these challenges doctors may need to convert the procedure to multi-incision surgery.

A Virtually Scarless Option

For patients who have been told they need gallbladder surgery, ask about single-site robotic, assisted surgery. This procedure is performed through a single incision using state-of-the-art, precision instruments. Patients who choose single site surgery experience a virtually scarless procedure since surgery is performed through only one incision in the belly button to dramatically limit visible scarring. The primary potential benefits* of single-site gall bladder include:

  • Minimal scarring
  • Minimal pain
  • Low blood loss
  • Fast recovery
  • Short hospital stay
  • High patient satisfaction

* As with any surgery, these benefits cannot be guaranteed since surgery is unique to each patient and procedure.

The Technology

Lodi Health uses the da Vinci Surgical System to overcome the limitations of manual laparoscopy. The system has enhanced capabilities, including high-definition 3D vision and a magnified view.

A specially trained and experience surgeon uses the da Vinci system, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside a patient’s body.

Though it is often called a “robot,” the daVinci system cannot act on its own; the surgery is performed entirely by an experienced doctor.

Together, the da Vinci system instruments allow the physician to perform gallbladder surgery through a single incision. As a result, patients may be able to get back to their lives without the recovery or scars that usually follow major surgery.

All surgeries involve the risk of major complications. Before you decide on any surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your situation.

Click here for a printable brochure on Single-Site Robotic-Assisted Gallbladder Surgery.

da Vinci Prostatectomy (dVP)

prostatectomy comparison395x159Referred to by many as robotic surgery for prostate cancer or robotic prostatectomy, da Vinci® Prostatectomy is more accurately a robot-assisted, minimally invasive surgery that is quickly becoming the preferred treatment for removal of the prostate following early diagnosis of prostate cancer. In fact, studies suggest that  da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today.1

Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

da Vinci Prostatectomy is performed with the assistance of the da Vinci Surgical System – the latest evolution in robotics technology. The da Vinci Surgical System enables surgeons to operate with unmatched precision and control using only a few small incisions. Recent studies suggest that da Vinci Prostatectomy may offer improved cancer control and a faster return to potency and continence.1 da Vinci Prostatectomy also offers these potential benefits:

  • Significantly less pain
  • Less blood loss
  • Fewer complications
  • Less scarring
  • A shorter hospital stay
  • And a faster return to normal daily activities

If you are a candidate for prostate surgery, talk to a surgeon who performs da Vinci Prostatectomy.

Find a da Vinci trained surgeon >

Most effective minimally invasive surgery in terms of cancer control, potency and continence, cancer control being defined in part by margin rates and PSA test scores. The following studies provide support for da Vinci Prostatectomy's effectiveness in these three areas: Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeon's outcomes. Urology. 2004 May;63(5):819-22. Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A, Hemal AK. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am. 2004 Nov;31(4):701-17. Tewari A, Srivasatava A, Menon M; Members of the VIP Team. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int. 2003 Aug;92(3):205-10. Please also see the Clinical References section of the site for additional clinical support.

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci® Surgical System visit www.davincisurgery.com.

Prostate Cancer & Treatment

The prostate is a male reproductive gland that produces a fluid found in semen. Located below the bladder and in front of the rectum, the prostate surrounds the urethra — the tube that empties urine from the bladder.

Prostate cancer affects the prostate gland and may spread to surrounding structures. While most men with prostate cancer have no symptoms, physician can find prostate cancer male anatomy 395x255during a regular checkup, using a combination of a blood test called a PSA and a digital rectal exam (DRE).

Nearly one in six American men will be diagnosed with prostate cancer during his lifetime.1 With greater awareness, prostate cancer detection is on the rise and mortality is declining. Moreover, better treatments are allowing more men to return to active and productive lives after treatment.

Treatment Options

If the you have an early diagnosis of prostate cancer, there is usually a range of treatment options. These may include conservative management, radiation therapy with either external bream or brachytherapy therapy, cryosurgery and prostatectomy – surgical removal of the prostate. Your treatment options will depend on a number of factors, including the stage of the disease, your age and health or personal preference.

Learn More

Find a da Vinci trained surgeon >

1. The National Prostate Cancer Coalitionhttp://zerocancer.org/education/treatment/surgery/

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci® Surgical System visit www.davincisurgery.com

Prostatectomy

The gold standard treatment option for men under 70 with early-stage, organ-confined cancer is surgical removal of the prostate using nerve-sparing radical prostatectomy. Prostatectomy is also the most widely used treatment for prostate cancer today in the US.1

male anatomy 395x355

The primary goal of prostatectomy is removal of the cancer. A secondary goal is to preserve urinary function and -- when applicable -- erectile function. Preservation of the nerves necessary for erections can be an extremely important goal for patients. These nerves run alongside the prostate and are often damaged when removing the prostate. A nerve-sparing prostatectomy attempts to preserve these nerves so that the patient may be able to return to his prior erectile function.

Types of Prostatectomy

Approaches to this procedure include traditional open surgery, conventional laparoscopic surgery or da Vinci ® Prostatectomy, which is a robot-assisted laparoscopic surgery.

With a traditional open procedure, your surgeon uses an 8-10 inch incision to access the prostate. This approach often results in substantial blood loss, a lengthy, uncomfortable recovery and a risk of impotence and incontinence.

Conventional laparoscopy uses a specialized surgical camera and rigid instruments to access and remove the prostate using a series of small incisions. This approach provides your surgeon with better visualization than an open approach. In addition, it provides patients the benefits of a minimally invasive procedure.

Despite these advantages, conventional laparoscopy relies on rigid instruments and standard 2D video, technical limitations that can be challenging for the surgeon. Because of these drawbacks, conventional laparoscopy doesn’t lend itself well to complex procedures like prostatectomy. Therefore, very few urologists use this approach for prostatectomy. Moreover, neither laparoscopy nor open surgery can provide adequate visualization for a very precise, nerve-sparing prostatectomy.

Learn More

Read about the potentially most effective, least invasive approach to prostatectomy – da Vinci® Prostatectomy.

Find a da Vinci trained surgeon >

1. The National Prostate Cancer Coalition: http://zerocancer.org home > education > treatment > treatment options > surgery

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci® Surgical System visit www.davincisurgery.com

Fibroids & Treatment Options

Uterine fibroids* are benign (non-cancerous) tumors occurring in at least one quarter of all women.1 They can grow underneath the uterine lining, inside the uterine wall, or outside the uterus.

Many women don’t feel any symptoms with uterine tumors or fibroids. But for others, these fibroids can cause excessive menstrual bleeding (also called menorrhagia), abnormal periods, uterine bleeding, pain, discomfort, frequent urination and infertility.2

Treatments include uterine fibroid embolization – which shrinks the tumor – and surgery. Surgical treatment for uterine tumors most often involves the surgeon removing the entire uterus, via hysterectomy.3

While hysterectomy is a proven way to resolve fibroids, it may not be the best surgical treatment for every woman. If, for example, you hope to later become pregnant, you may want to consider alternatives to hysterectomy like myomectomy. Myomectomy is a uterine-preserving procedure performed to remove uterine fibroids.

Types of Myomectomy

Each year, roughly 65,000 myomectomies are performed in the U.S.4 The conventional approach to myomectomy is open surgery, through a large abdominal incision.5 After cutting around and removing each uterine fibroid, the surgeon must carefully repair the uterine wall to minimize potential uterine bleeding, infection and scarring. Proper repair is also critical to reducing the risk of uterine rupture during future pregnancies. Menorrhagia is extensive menstrual bleeding.

While myomectomy is also performed laparoscopically, this approach can be challenging for the surgeon, and may compromise results compared to open surgery.6 Laparoscopic myomectomies often take longer than open abdominal myomectomies, and up to 28% are converted during surgery to an open abdominal incision.7

A new category of minimally invasive myomectomy, da Vinci® Myomectomy, combines the best of open and laparoscopic surgery. With the assistance of the da Vinci Surgical System – the latest evolution in robotics technology – surgeons may remove uterine fibroids through small incisions with unmatched precision and control.

Learn more

If you would like to explore whether you are a candidate for myomectomy, ask your doctor. 

Find a da Vinci trained surgeon >

* Uterine fibroids are also called fibroids, uterine tumors, leiomyomata (singular – leiomyoma) and myomas or myomata (singular – myoma)

1. Newbold RR, DiAugustine RP, Risinger JI, Everitt JI, Walmer DK, Parrott EC, Dixon D. Advances in uterine leiomyoma research: conference overview, summary, and future research recommendations. Environ Health Perspect. 2000 Oct;108 Suppl 5:769-73. Review.

2. National Institutes of Health: Fast Facts about Uterine Fibroids. www.nichd.nih.gov/publications/pubs/fibroids/sub1.htm#where

3. Becker ER, Spalding J, DuChane J, Horowitz IR. Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998-2002. J Natl Med Assoc. 2005 Oct;97(10):1336-42.

4. Lumsden MA.Embolization versus myomectomy versus hysterectomy: Which is best, when? Hum Reprod. 2002; 17:253-259. Review.

5. Becker ER, Spalding J, DuChane J, Horowitz IR. Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998-2002. J Natl Med Assoc. 2005 Oct;97(10):1336-42.

6 .Kristen A. Wolanske, MD; Roy L. Gordon, MD. Uterine Artery Embolization: Where Does it Stand in the Management of Uterine Leiomyomas? Part 2. Appl Radiol 33(10):18-25, 2004. Medscape.10/27/2004.

7. Advincula AP, Song A, Burke W, Reynolds RK. Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2004 Nov;11(4):511-8.

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci® Surgical System visit www.davincisurgery.com.