Laparoscopic/Hand-Assisted Colectomy
This surgery allows for tactile sensation and depth perception, which results in less OR time. It also allows for insertion of a hand into the abdominal cavity, enabling the surgeon to perform the operation according to the principles of an open surgery, while retaining many of the advantages of a laparoscopic procedure.
Physicians: da Vinci Robotic Vasectomy Reversal
This procedure is performed by making a small incision in the scrotal skin over the vasectomy site. The disconnected end of the vas deferns are located and closed. The muscular layer and surrounding connective tissue are reconnected and the incision is closed.
Physicians: Laparoscopic Hiatal Hernia Surgery for Reflux Disease (GERD)
This procedure is used in the treatment of Gastroesophageal Reflux, which occurs when the lower esophageal sphincter (the valve between the esophagus and stomach) becomes weak, allowing acid from the stomach to flow backward into the esophagus causing Heartburn. Heartburn is the most common symptom of GERD. Other symptoms include regurgitation of fluid when the patient lays down or bends over, food sticking when the patient swallows, pain in the chest or upper abdomen, and waking at night coughing.
The surgeon makes small incisions and inserts a laparoscope to show the operating team inside the patient. Very small instruments are introduced to create a pathway to repair the hernia and wrap a small portion of the stomach aaround the esophagus like a doughnut. That "doughnut", called a Nissen Fundoplication, makes a new valve that is extremely effective in preventing reflux. The success rate with this procedure is over 90% as reported in several large series by experienced surgeons.
The recovery time is a 23 hour hospital stay, a gradual return to regular diet over a 4 day period, driving a car in 4 – 5 days. Return to normal activity in 1 – 2 weeks.
Physicians: Laparoscopic Gallbladder
Gallbladder surgery is the best method of treating gallstones that cause symptoms. The first laparoscopic gallbladder surgery in Virginia was performed at HDH by Dr. Kelley and the first dedicated laparoscopic surgery team in the region January 1990.
Laparoscopic Gallbladder surgery is performed through several small incisions rather than one large incision. The laparoscope is inserted through a tiny incision made around the belly button. Three other ¼-inch incisions are made and instruments are inserted in the abdomen. The surgeon will remove the gallbladder through one of these incisions.
Recovery time is about one week, which is a dramatic improvement over the traditional "open" surgery.
Physicians: Single Incision Laparoscopic Gallbladder Surgery
Multiple instruments are inserted through one incision to further reduce the trauma of surgery and hide the one small scar inside the belly button.
This has cosmetic advantages over the multiple incision laparoscopic surgery. The first Single Incision Laparoscopic Surgery (SILS) in the Mid-Atlantic states was performed by Dr. Kelley in July, 2008, at HDH. The first SILS gallbladder surgery and first SILS antireflux operation in the Mid-Atlantic states were performed by Dr, Kelley at HDH, as well as the first SILS bile duct exploration in the world.
Physicians: Laparoscopic Hernia Repair
Hernias occur when soft tissue – usually part of the intestine – protrudes through a weak point or tear in your lower abdominal wall. The resulting bulge can be painful – especially when you cough, bend over or lift a heavy object.
A Laparoscopic Hernia repair involves the surgeon inserting instruments through small incisions in the abdomen through which the surgeon is able to visualize and repair the hernia. Three small incisions are made in the abdomen, one near the belly button and the other incisions lower down. The laparoscope is inserted allowing the surgeon to visualize the area on a T.V. monitor. Special instruments are inserted into the incisions and the hernia is repaired with Mesh, for reinforcement. The incisions are closed with one to two stitches.
Patients return to driving in 3 days. The recovery time is one to two weeks and is shorter than a traditional hernia repair, especially if hernias are repaired on both sides. The smaller incisions cause less pain for the patient.
Physicians: da Vinci Robotic Hysterectomy
The da Vinci Robotic hysterectomy is performed through several small, one to two centimeter incisions, unlike a traditional radical hysterectomy that requires a six to 12-inch (approximately 15 to 30-cm) incision in the abdomen. While highly effective, traditional hysterectomies are often accompanied by significant pain and a lengthy recovery process that can last up to several months. In contrast, women who undergo the da Vinci Robotic hysterectomy may benefit from reduced trauma to the body, less pain and discomfort, less scarring, reduced blood loss, a decreased risk of infection, a shorter hospital stay, and a faster recovery and return to normal daily activities.
Physicians: Scarless (SILSTM) Hysterectomy
The SILSTM Hysterectomy allows for the removal of the uterus through a small incision made in the belly button. To perform this procedure, a SILSTM Port (a soft and flexible instrument equipped with three distinct openings which allows for the use of three surgical devices at the same time) is inserted through an incision in the belly button. When the surgery is complete, the SILSTM Port is removed from the belly button, leaving one small incision which may not be visible upon healing. The recovery time is about two weeks.
Physicians: Minimally Invasive Aortic Valve Repair
Blood is pumped through your heart in only one direction. Heart valves play a key role in this one-way blood flow, opening and closing with each heartbeat. Pressure changes on either side of the valves cause them to open their flap-like "doors" at just the right time, and then close tightly to prevent a backflow of blood.
If damage to the valve is severe, surgery to repair or replace the valve may be needed.
Minimally Invasive Aortic Valve Repair Surgery is performed to either repair or replace the aortic valve. A 6 to 10 centimeter incision is made between the ribs to access the ascending aorta as it rises from the heart.
This approach offers the following advantages: it is a more cosmetic appealing result, less invasive approach with less tissue damage, less blood loss and a shorter hospital stay. This is a good option for seniors, who are at or below ideal body weight.
Minimally Invasive Fetal Surgery
Approximately 10 to 15 percent of monozygotic or identical twin pregnancies are complicated by Twin-to-Twin Transfusion Syndrome (TTTS). This condition occurs when blood passes disproportionately between the two babies through connecting blood vessels within their single, shared placenta. In this condition, one baby gets too much blood, which may overload their cardiovascular system and lead to heart failure while the other does not get enough blood and can experience severe anemia.
This procedure uses real-time video imagery from fetoscopy and ultrasonography to guide very small surgical instruments into the uterus in order to surgically help the fetus. This is less invasive than open fetal surgery, which reduces the mother's post-op recovery and lessens the troubles with pre-term labor.
Physicians: da Vinci Robotic-Assisted Partial Nephrectomy
da Vinci Robotic-assisted partial nephrectomy is a popular choice for the treatment of localized renal cell cancer. It is a minimally invasive procedure that removes only the portion of the kidney involved with renal cell cancer. It preserves the portion of the kidney uninvolved with cancer. It ultimately gives patients the chance to have as much kidney function as possible. The robotic system helps the surgeon precisely perform the complex steps of the surgery using only small incisions. Combining surgeon expertise with an experienced robotic team usually leads to a quick postoperative recovery and excellent postoperative results.
Physicians: Laparoscopic Donor Nephrectomy
Laparoscopic Donor Nephrectomy is the minimally invasive procedure for the removal of the kidney from a living donor to a recipient. Four small incisions are made in the abdomen for the insertion of instruments. The kidney is removed through a fifth larger incision and prepared for immediate implantation. This procedure minimizes the trauma of access to internal organs.
The recovery time is 1 to 2 weeks for the patient to return to normal activities.
Physicians: Laparoscopic Radical Nephrectomy
Laparoscopic radical nephrectomy is one of the most popular choices for the treatment of localized renal cell cancer when partial nephrectomy is not recommended. Laparoscopic radical nephrectomy is a minimally invasive procedure that removes the entire kidney involved with cancer. The da Vinci Robotic system is usually not required since complex reconstruction is not involved. Surgeon expertise and an experienced laparoscopic team are crucial to postoperative results.
Physicians: Single Incision Laparoscopic (SILSTM) Nephrectomy
SILSTM Nephrectomy can replace the Laparoscopic Radical Nephrectomy in select cases. The SILSTM is a technique to minimize the size and number of surgical scars while performing the same goals of surgery as the Laparoscopic Radical Nephrectomy.
Physicians: Laparoscopic Liver Biopsy or Resection
This procedure is performed to obtain tissue samples from the liver. A small incision is made in the abdomen usually just below the rib cage. A cannula is inserted in the incision and the abdomen is inflated with gas which allows the surgeon to work inside the abdominal cavity. Patients will remain in the hospital for 1 to 2 hours post procedure. Patients return to normal activities in 1 to 2 days.
Intra-operative MRI
This technology is the first of its kind in the Mid-Atlantic region. It provides surgeons the ability to have MRIs taken during neurosurgery. These real time immediate images will enable surgeons to view images during the operation rather than after the surgery. This allows them to verify that all of the tumor has been removed prior to ending the surgery, while also reducing the risk of damage to healthy brain tissue. This maximizes the patient's chance for a cure, reduces their need for a second surgery and optimizes post-operative neurologic functional capacity.
Physicians: Video Thoracascopy
Video Thoracascopy is used to repair a collapsed lung, to examine a biopsy and stage a mass in the lung. This procedure is often referred to as "VATS." It is performed using a small video camera introduced into the patient's chest via a scope. Through the scope, your surgeon is able to view the anatomy. Instruments are inserted into the chest via a small incision.
Physicians: Endoscopically-Assisted Thyroid Surgery
Endoscopically-Assisted Thyroid Surgery is performed through an incision 1/3 the size of a typical thyroidectomy incision. The surgeon uses a laparoscope to visualize the important structures while performing the thyroid gland removal. The cosmetic results are superior to traditional thyroid surgery and most patients experience less pain due to the smaller incision.
Physicians: da Vinci Robotic-Assisted Pyeloplasty
da Vinci Robotic-assisted pyeloplasty is one of the most popular choices for the treatment of ureteropelvic junction (UPJ) obstruction. It is a minimally invasive procedure that removes the obstructed, diseased portion of the ureter and reconnects the remaining healthy ureter to the renal pelvis. The robotic system helps the surgeon precisely perform the complex steps of the surgery using only small incisions. Combining surgeon expertise with an experienced robotic team usually leads to a quick postoperative recovery and excellent postoperative results.
Physicians: da Vinci Robotic-Assisted Radical Prostatectomy
da Vinci Robotic-assisted radical prostatectomy is one of the most popular choices for the treatment of localized prostate cancer. It is a minimally invasive procedure that removes the prostate and related structures. The robotic system helps the surgeon precisely perform the complex steps of the surgery using only small incisions. Combining surgeon expertise with an experienced robotic team usually leads to a quick postoperative recovery and excellent postoperative results.
Physicians: Robotic Adrenalectomy
da Vinci Robotic-assisted adrenalectomy is a novel choice for the treatment a variety of adrenal disorders including tumors and hormonal imbalances. It is a minimally invasive procedure that removes the entire adrenal gland. People have a pair of adrenal glands located in a delicate position on either side of the abdomen. The robotic system helps the surgeon perform a precise operation through small incisions. Combining surgeon expertise with an experienced robotic team usually leads to a quick postoperative recovery and excellent postoperative results.
Physicians: Pelvic Floor Repair (Sacrocolpopexy)
Sacrocolpopexy is a gynecological procedure that surgically corrects vaginal or uterine prolapse. Prolapse occurs when the connective tissue around a pelvic floor organ (vagina, uterus, bladder or rectum) weakens to the point that the organ slips out of place. In a sacrocolpopexy, a surgeon uses mesh to hold the prolapsed organ in its correct anatomical position. Vaginal and uterine prolapse are more common among older women who have delivered children vaginally.
Traditionally, sacrocolpopexy has been performed as an open surgery that involves making a six to 12-inch incision in the abdomen to access the pelvic organs. As with open hysterectomy, this kind of sacrocolpopexy often results in significant pain and a prolonged recovery. However, with da Vinci Robotic, this same procedure can be performed through tiny, dime-size incisions, potentially resulting in less pain, scarring, blood loss and recovery time.
Physicians: Video Assisted Thoracic Surgery (VATS)
VATS is performed using a small video camera and special instruments introduced into the patient's chest via several small incisions between the ribs. Through the scope, your surgeon is able to view the structures inside the chest cavity including the lungs, heart, esophagus and thymus gland. Many procedures are performed using VATS, such as lung biopsies, removal of lung cancer, drainage of fluid from around the lung, removal of bubbles or “blebs” that cause the lung to collapse and others. The use of small incisions with VATS results in less post-operative pain and quicker recovery and return to normal activities.
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