Robotic Prostatectomy & Pyeloplasty

 

Video Showcase - click the pictures below for informative videos

  • West Jeff Urology Specialists Ryan Glass daVinci
    daVinci Surgical Robot
  • West Jeff Urology Specialists Ryan Glass
    Prostate Cancer Awareness

da Vinci Minimally Invasive Surgery

WJMC Urology Specialists - TreatmentsMinimally Invasive Surgery (MIS) allows physicians to perform many kinds of major surgery with a variety of benefits for the patient: less trauma and pain, minimal scarring, faster recovery and shorter hospital stays. Surgeries are performed through small incisions, which replace the large incisions needed for conventional open surgeries.

The benefits of MIS are numerous. Traditional surgery often requires a lengthy hospital stay and weeks of recovery. With minimally invasive surgery, the goal is to accomplish internal repair while leaving the body surface as natural as it was prior to surgery. Many procedures require fewer days in the hospital and promote reduced recovery time. Patients can often get back to their normal routines more quickly.

Using a robotic-assisted, minimally invasive approach further minimizes the physical and emotional impact of surgery on patients. By dramatically enhancing visualization, precision, control and dexterity, the da Vinci System overcomes the limitations of traditional laparoscopic technology, helping physicians to perform complex surgery in a manner never before experienced.

The da Vinci Surgical System extends the surgeon’s capabilities to provide these significant benefits: WJMC Urology Specialists - Treatments

  • Enhanced 3D view of the operating area
  • Improved dexterity
  • Greater surgical precision
  • Improved access
  • Increased range of motion
  • Reproducibility

By enhancing surgical capabilities, da Vinci Surgery offers a number of potential benefits, including:

  • Less pain following the operation
  • Less risk of infection
  • Less anesthesia
  • Less blood loss
  • Shorter hospital stay
  • Faster and more complete recovery
  • Quicker return to normal daily activities

Robotic Prostatectomy - What To Expect

Pre-Operative

WJMC Urology Specialists - TreatmentsThe patient will have a physical examination and discuss the various types of anesthesia with the anesthesiologist. This visit is arranged by the doctor and will likely occur the week before surgery. The evening before surgery the patient follows instructions for bowel preparation as provided by the doctor.

Day of Surgery

Shortly before the operation, anesthesia is administered and the patient goes to sleep for the duration of the operation, which typically lasts 2-4 hours. The procedure begins when the patient’s abdomen is inflated with carbon dioxide gas, creating an operating space for the surgeon. Next, six small incisions, 1/4 to 1/2 inch in length, are made in the patient’s abdomen and ports are inserted to keep the incisions open.

During the procedure, the surgeon uses the da Vinci System’s laparoscopic surgical instruments and video camera, via the temporary ports, to direct the dissection of the prostate gland and adjacent tissue. If deemed appropriate, the surgeon tries to preserve the nerves attached to the patient’s prostate gland. At the end of the surgery, the ports are removed from the patient’s abdomen and the remaining incisions are closed with sutures.

WJMC Urology Specialists - Treatments

Post-Operative

The patient wakes up very groggy and with a urinary catheter in place. He will likely spend one night in the hospital resting and recovering from the effects of the anesthesia. As the anesthesia wears off, there may be some discomfort, for which pain medication may be prescribed. During this time, the medical team gets the patient sitting, standing and eventually walking around, which is recommended throughout the recovery period. Because a catheter typically remains in place for approximately 7 days, the doctor will review guidelines for use that will ease discomfort and ensure proper function of the catheter during this time.

Recovery Period

WJMC Urology Specialists - TreatmentsThe first week post-operatively will likely be spent resting; however, frequent walks are encouraged. Depending on the individual, regular activities may resume as soon as soon as a few days after surgery; straining and heavy lifting is discouraged for the first four weeks post-operatively. Approximately one week after surgery, a post-operative follow-up is scheduled, at which time bladder function may be assessed. This is done by filling the bladder with saline via the catheter, removing the catheter and then allowing the patient to void naturally. Some incontinence after surgery is normal and is typically managed with medication until bladder control resumes. Erectile dysfunction may also be a side effect of surgery. Like incontinence, this side effect may be discussed with the doctor and managed with medication until it lessens or completely resolves over time.

Follow-Up Care

After treatment for prostate cancer, the doctor will want to watch the patient carefully, checking to see if his cancer recurs or spreads further. The doctor should also outline a follow-up plan. This plan usually includes regular doctor visits, PSA blood tests and digital rectal exams, which will likely begin within a few months of finishing treatment. Most doctors recommend PSA tests about every 6 months for the first 5 years after treatment, and at least yearly after that.

Robotic Pyeloplasty

The kidneys are two small organs located behind the abdomen, on each side of the spine. By producing urine, kidneys remove toxic by-products and excess fluids from the body, which helps maintain a critical balance of salt, potassium and acid.

A common condition affecting the kidneys is blockage of the ureters, the tubes that transport urine from the kidneys to the bladder. Blockages of the ureters can be present from birth or acquired through illness or injury, and can create serious side effects like infections and kidney stones. If left untreated, blockages can cause chronic pain and may damage the kidney over time.

Cancer, a second condition affecting the kidneys, can form in the small tubes inside the kidney, which are used for filtering blood, and in the center of the kidney where urine collects.

Treatment Options

Non-cancerous kidney conditions involving a blockage can usually be treated by removing it; depending on the type of blockage, surgery may be used. Kidney cancer, on the other hand, is relatively resistant to radiation and chemotherapy.

As a result, the gold standard treatment for localized kidney cancer is removal of the kidney or kidney tumors.

Kidney surgery is traditionally performed using an open approach, which requires a large abdominal incision. Another approach, conventional laparoscopy, is less invasive, but limits the doctor’s dexterity, visualization and control, compared to open surgery.

da Vinci® for Kidney Conditions

If your doctor recommends surgery for a kidney condition, you may be a candidate for a new, minimally invasive approach — da Vinci Surgery.

da Vinci Surgery uses state-of-the-art technology to help your doctor perform a more precise operation than conventional instrumentation allows. It offers numerous potential benefits over a conventional open surgery, including:

  • Significantly less pain
  • Less blood loss
  • Fewer transfusions
  • Less risk of infection
  • Less scarring
  • Shorter hospital stay
  • Shorter recovery time
  • Increased potential for kidney preservation in certain prescribed cancer operations
  • Better clinical outcomes, in many cases

WJMC Urology Specialists - Treatments

da Vinci Surgery for kidney conditions incorporates the best techniques of open surgery and applies them to a robotic-assisted, minimally invasive approach.

Frequently Asked Questions

(Q). What is Minimally Invasive Surgery (MIS)?

(A). MIS is surgery typically performed through small incisions, or operating ports, rather than large incisions. This can potentially result in shorter recovery times, fewer complications, reduced hospitalization costs and reduced trauma to the patient. While MIS has become standard-of-care for particular surgical procedures, it has not been widely adopted for more complex or delicate procedures - for example, prostatectomy and mitral valve repair.

Intuitive Surgical believes that surgeons have been slow to adopt MIS for complex procedures because they generally find that fine-tissue manipulation – such as dissecting and suturing – is more difficult than in open surgery. Intuitive Surgical's technology, however, enables the use of MIS techniques for complex procedures.

(Q).Why do we need a new way to do minimally invasive?

WJMC Urology Specialists - Treatments(A). Despite the widespread use of minimally invasive or laparoscopic surgery in today's hospitals, adoption of laparoscopic techniques, for the most part, has been limited to a few routine procedures. This is due mostly to the limited capabilities of traditional laparoscopic technology, including standard video and rigid instruments, which surgeons must rely on to operate through small incisions.

In traditional open surgery, the physician makes a long incision and then widens it to access the anatomy. In traditional minimally invasive surgery - which is widely used for routine procedures - the surgeon operates using rigid, hand-operated instruments, which are passed through small incisions and views the anatomy on a standard video monitor. Neither this laparoscopic instrumentation nor the video monitor can provide the surgeon with the excellent visualization needed to perform complex surgery like mitral valve repair or nerve-sparing prostatectomy.

(Q). What are the benefits of da Vinci Surgery compared with traditional methods of surgery?

(A). Some of the major benefits experienced by surgeons using the da Vinci Surgical System over traditional approaches have been greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access. Benefits experienced by patients may include a shorter hospital stay, less pain, less risk of infection, less blood loss, fewer transfusions, less scarring, faster recovery and a quicker return to normal daily activities. None of these benefits can be guaranteed, as surgery is necessarily both patient- and procedure-specific.

(Q). Where is the da Vinci Surgical System being used now?

(A). Currently, The da Vinci Surgical System is being used in hundreds of locations worldwide, in major centers in the United States, Austria, Belgium, Canada, Denmark, France, Germany, Italy, India, Japan, the Netherlands, Romania, Saudi Arabia, Singapore, Sweden, Switzerland, United Kingdom, Australia and Turkey.

(Q). Has the da Vinci Surgical System been cleared by the FDA?

(A). The U.S. Food and Drug Administration (FDA) has cleared the da Vinci Surgical System for a wide range of procedures. .

(Q). Is da Vinci Surgery covered by insurance?

WJMC Urology Specialists - Treatments(A). da Vinci Surgery is categorized as robot-assisted minimally invasive surgery, so any insurance that covers minimally invasive surgery generally covers da Vinci Surgery. This is true for widely held insurance plans like Medicare. It is important to note that your coverage will depend on your plan and benefits package. For specifics regarding reimbursement for da Vinci Surgery, or if you have been denied coverage, please call the Reimbursement Hotline at 1-888-868-4647 ext. 3128. From outside the United States, please call 33-1-39-04-26-90.

(Q). Will the da Vinci Surgical System make the surgeon unnecessary?

(A). On the contrary, the da Vinci System enables surgeons to be more precise, advancing their technique and enhancing their capability in performing complex minimally invasive surgery. The system replicates the surgeon's movements in real time. It cannot be programmed, nor can it make decisions on its own to move in any way or perform any type of surgical maneuver without the surgeon's input.

(Q). Is a surgeon using the da Vinci Surgical System operating in "virtual reality"?

(A). Although seated at a console a few feet away from the patient, the surgeon views an actual image of the surgical field while operating in real-time, through tiny incisions, using miniaturized, wristed instruments. At no time does the surgeon see a virtual image or program/command the system to perform any maneuver on its own/outside of the surgeon's direct, real-time control.

(Q). Is this telesurgery? Can you operate over long distances?

(A). The da Vinci Surgical System can theoretically be used to operate over long distances. This capability, however, is not the primary focus of the company and thus is not available with the current da Vinci Surgical System.

(Q). While using the da Vinci Surgical System, can the surgeon feel anything inside the patient's chest or abdomen?

(A). The system relays some force feedback sensations from the operative field back to the surgeon throughout the procedure. This force feedback provides a substitute for tactile sensation and is augmented by the enhanced vision provided by the high-resolution 3D view.

(Q). What procedures have been performed using the da Vinci Surgical System? What additional procedures are possible?

(A). The da Vinci System is a robotic surgical platform designed to enable complex procedures of all types to be performed through 1-2 cm incisions or operating “ports.” To date, tens of thousands of procedures including general, urologic, gynecologic, thoracoscopic, and thoracoscopically-assisted cardiotomy procedures have been performed using the da Vinci Surgical System.

(Q). Why is it called the da Vinci Surgical System?

(A). The product is called "da Vinci" in part because Leonardo da Vinci invented the first robot. He also used unparalleled anatomical accuracy and three-dimensional details to bring his masterpieces to life. The da Vinci Surgical System similarly provides physicians with such enhanced detail and precision that the System can simulate an open surgical environment while allowing operation through tiny incisions.