Minimally Invasive and Robotic Surgery

Urology Procedures

Robotic surgery has become the technique of choice for Highland’s prominent urology surgeons to address conditions and cancers of the urethra, prostate, bladder and kidneys for men. Our gynecology urology surgeons treat women for incontinence and pelvic floor disorders.

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da Vinci Cystectomy

A cystectomy is the removal of all or part of the bladder and possibly the removal of nearby lymph nodes and organs that may contain cancer. If the bladder is removed, the surgeon creates a new way for urine to leave the body. In some cases, a urinary diversion is performed to create a new way for the body to store and pass urine. 4
da Vinci Cystectomy incorporates the best techniques of open surgery – including comprehensive cancer control – and applies them to a robotic-assisted, minimally invasive approach. da Vinci Cystectomy offers patients several potential benefits over open surgery, including:

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient, condition and procedure. It is important to talk to your doctor about all treatment options, including the risks and benefits. This information can help you make the best decision for your situation.

Kidney-Incision_Comparison

Open Kidney(Nephrectomy) Incision - da Vinci Kidney(Nephrectomy)

1. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Nguyen PL, Choueiri TK, Kibel AS, Hu JC. Comparative Analysis of Outcomes and Costs Following Open Radical Cystectomy Versus Robot-Assisted Laparoscopic Radical Cystectomy: Results From the US Nationwide Inpatient Sample. Eur Urol. 2012 Jun;61(6):1239-44. Epub 2012 Mar 30.
2. Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS. Prospective Randomized Controlled Trial of Robotic versus Open Radical Cystectomy for Bladder Cancer: Perioperative and Pathologic Results, Eur Urol(2009), doi: 10.1016/j.eururo.2009.10.024.
3. Ng CK, Kauffman EC, Lee MM, Otto BJ, Portnoff A, Ehrlich JR, Schwartz MJ, Wang GJ, Scherr DS.  A Comparison of Postoperative Complications in Open versus Robotic Cystectomy. Eur Urol(2009) doi: 10.1016/j.eururo.2009.06.001

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.

Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com

Partial Nephrectomy

If your doctor recommends surgery for a kidney disease such as kidney cancer, you may be a candidate for a minimally invasive, kidney-sparing surgery. Depending on your disease state and tumor location, you may not have to lose your entire kidney to surgery. A surgical technique called partial nephrectomy removes only the diseased part of your kidney while sparing the healthy, functioning kidney tissue.
Sparing kidney tissue is important because studies show that patients who have their entire kidney removed are more likely to suffer from chronic kidney disease (CKD) after surgery than patients who received a kidney-sparing partial nephrectomy.1
In fact, the American Urological Association states that partial nephrectomy is the gold standard treatment option for small to medium-sized kidney tumors or masses.2
The da Vinci Surgical System uses state-of-the-art technology to help your doctor provide the gold standard treatment, where indicated, and also perform a more precise operation. da Vinci offers several potential benefits to patients facing kidney surgery, including:

 

If your doctor is able to preserve your healthy, functioning kidney tissue, this can help to prevent future kidney disease and even dialysis.
da Vinci Surgery for kidney conditions uses the tried and true techniques of open surgery and applies them to a robotic-assisted, minimally invasive approach. With the benefits of da Vinci Surgery, doctors may be able to perform a partial nephrectomy or kidney-sparing surgery (healthy, functioning kidney tissue is spared) to help minimize the onset of chronic kidney disease.
The precision and dexterity of the da Vinci Surgical System's advanced instrumentation provides for a minimally invasive approach to treating kidney disorders and kidney cancer.
As with any surgery, these benefits cannot be guaranteed since surgery is unique to each patient, condition and procedure.

1. Huang WC, Elkin EB, Levey AS, Jang TL, Russo P; Partial Nephrectomy Versus Radical Nephrectomy in Patients With Small Renal Tumors-Is there a Difference in Mortality and Cardiovascular Outcomes; The Journal of Urology, Vol. 181, 55-62, January 2009.
2. Guide for Management of  Clinical Stage 1 Renal Mass, 2009; American Urological Association Education and Research, Inc. www.auanet.org, URL: http://www.auanet.org/content/media/renalmass09.pdf?CFID=3292545&CFTOKEN=94898243&jsessionid=843026c2999c59bc411027365115951a1118
3. Benway BM, Wang AJ, Cabello JC, Bhayani SB; Robotic Partial Nephrectomy with Sliding-Clip Renorrhaphy: Technique and Outcomes; European Association of Urology, Accepted December 28, 2008. Published online ahead of print on January 7, 2009
4. Rogers CG, Menon M, Weise ES, Robotic partial nephrectomy: a multi-institutional analysis; J Robotic Surgery (2008) 2:141-143 DOI 10.1007/s11701-008-0098-2
5. Bhayani SB, Das N., Robotic-assisted laparoscopic partial nephrectomy for suspected renal cell carcinoma. BMC Surgery 2008, 8:16 doi:10.1186/1471-2482-8-16.

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.

Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com

da Vinci Prostatectomy

More U.S. men choose da Vinci Surgery than any other treatment for prostate cancer,1 and more and more men worldwide facing prostate cancer are choosing da Vinci Surgery.  
Studies show that, compared to open surgery, experienced da Vinci surgeons achieve better cancer control - lower positive margin rates. Positive margin rates are a measure of cancer cells left behind – lower is better .2,3,4
Studies also show patients who are potent prior to surgery experience a faster return of erectile function than patients who have open surgery. 5,6
Finally, recent studies show more patients have full return of urinary continence within 6 months as compared to patients having open surgery 4,5,6

 

1. Claim based on 2008 U.S. data. Data on file at Intuitive Surgical, Inc.
2. Weerakoon M, Sengupta S, Sethi K, Ischia J, Webb DR. Predictors of positive surgical margins at open and robot-assisted laparoscopic radical prostatectomy: a single surgeon series. J Robotic Surg (2011) DOI 10.1007/s11701-011-0313-4.
3. Coronato EE, Harmon JD, Ginsberg PC, Harkaway RC, Singh K, Braitman L, Sloane BB, Jaffe JS. A multi-institutional comparison of radical retropubic prostatectomy, radical perineal prostatectomy, and robot-assisted laparoscopic prostatectomy for treatment of localized prostate cancer. J Robotic Surg (2009) 3:175-178.
4. Health Information and Quality Authority (HIQA), reporting to the Minister of Health-Ireland. Health technology assessment of robot-assisted surgery in selected surgical procedures, 21 September 2011.
5. Rocco B, Matei DV, Melegari S, Ospina JC, Mazzoleni F, Errico G, Mastropasqua M, Santoro L, Detti S, de Cobelli O. Robotic vs open prostatectomy in a laparoscopically naive centre: a matched-pair analysis. BJU Int. 2009 Oct;104(7):991-5. Epub 2009 May 5.
6. Ficarra V, Novara G, Fracalanza S, D'Elia C, Secco S, Iafrate M, Cavalleri S, Artibani W. A prospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int. 2009 Aug;104(4):534-9. Epub 2009 Mar 5.
7. Ho C, Tsakonas E, Tran K, Cimon K, Severn M, Mierzwinski-Urban M, Corcos J, Pautler S. Robot-Assisted Surgery Compared with Open Surgery and Laparoscopic Surgery: Clinical Effectiveness and Economic Analyses [Internet]. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH); 2011 (Technology report no. 137).
8. Hohwu L, Akre O, Pedersen KV, Jonsson M, Nielsen CV, Gustafsson O. Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: A comparison of length of sick leave. Scand. J. Urol. Nephrol. Apr 7 2009:1-6.
9. Menon M, Tewari A, Baize B, Guillonneau B, Vallancien G. Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology. 2002 Nov;60(5):864-8.
10. Miller J, Smith A, Kouba E, Wallen E, Pruthi RS. Prospective evaluation of short-term impact and recovery of health related quality of life in men undergoing robotic assisted laparoscopic radical prostatectomy versus open radical prostatectomy. J Urol. 2007 Sep;178(3 Pt 1):854-8; discussion 859. Epub 2007 Jul 16.
11. Carlsson S, Nilsson AE, Schumacher MC, Jonsson MN, Volz DS, Steineck G, Wiklund PN. Surgery-related complications in 1253 robot-assisted and 485 open retropubic radical prostatectomies at the Karolinska University Hospital, Sweden. Urology. 2010 May;75(5):1092-7.

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.

Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com

    • • Less risk of death1
    • • Less blood loss 2,3
    • • Lower risk of major complications 1,3
    • • Less narcotic pain medicine needed2
    • • Less use of IV feeding tube1
    • • Quicker recovery of bowel function2
    • • Shorter hospital stay3
    • • Minimal scarring
    • Excellent clinical outcomes and cancer control 3
    • Short hospital stay 4
    • Low blood loss 3,4
    • Precise tumor removal and kidney reconstruction 4,5
    • Excellent chance of preserving the kidney, in certain operations 5
    • Low rate of operative complications 5
    • Shorter hospital stay 4,5,6,7,8
    • Less blood loss 4,5,6,7,9,10,11
    • Less need for blood tranfusion 4,6,7,9,11
    • Lower risk of complications 4,7,11
    • Lower risk of wound infection 11
    • Fewer days with catheter 5
    • Less pain 9
    • Faster recovery 10 and return to normal activities 8