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Robotic Surgery

Robotic surgery is an advanced type of laparoscopic or minimally invasive surgery. This allows the surgeon to make small cuts to perform the surgery inside the abdominal cavity. The advantage of the robotic platform lies with improved 3D visualization and increased instrument dexterity over standard laparoscopic technique. In other words, If I can see better then I can dissect the tissues in a more controlled fashion. This reduces the inflammatory process therby improving pain control and optimizing recovery.

However, The DaVinci robot can be intimidating for the patient when entering the operating room. I want you to think of it as another tool, that helps me perform your surgery more efficiently.

Robotic Hernia Surgery

A hernia is a tear in the abdominal wall leading to protrusion of internal organs. The most common indication for repair includes pain, discomfort, limiting daily activities, or other symptoms. Robotic repair provides a novel minimally invasive approach that reduces pain and improves recovery time. Types of hernias include

Inguinal/femoral hernias

Ventral hernias

Umbilical hernias

Incisional hernias

Hiatal/Paraesophageal/diaphragmatic Hernias

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Emergency General Surgery

Time-sensitive surgical conditions can be potentially life-threatening requiring prompt surgical intervention. Examples of these conditions include

Acute appendicitis

Acute cholecystitis

Biliary obstructions

Small bowel perforation

Gastric or peptic ulcer perforation

Bowel obstruction

Colon Perforation

Colon Obstruction

Diverticulitis

Bowel Ischemia

Necrotizing Fasciitis

Robotic Colon Surgery

A section of the colon is removed and a new connection is fashioned inside the body. This helps to re-establish continuity of the gastrointestinal tract. The robotic platform provides better visualization and improved anastomosis (connection) technology. Indications for colon surgery include:

Colon and Rectal Cancer

Certain types of Appendiceal cancer

Polyps that are too large to be resected during colonoscopy

Diverticulitis, Acute and Recurrent

Colonic Obstructions

Rectal prolapse

Volvulus or Twisting of the colon

Perforation or rupture

Robotic Gallbladder Surgery

Gallbladder disease can cause acute and chronic pain particularly after meals rich in fats. Robotic cholecystectomy (gallbladder) is performed for a variety of conditions including.

Gallstones

Cholecystitis, Acute and Chronic

Choledocholithiasis

Biliary Pancreatitis

Gallbladder Polyps/Cancer

Biliary Dyskinesia

Laparoscopic Appendectomy

The appendix is finger sac like structure at the base of the cecum. It becomes problematic when the appendix gets obstructed or infected which can lead to perforation. Prompt appendectomy is the main course of treatment. Indications for appendectomy include

Appendicitis

Chron’s disease

Appendiceal neoplasms

Abdominal pain

Appendix polyps

Colonoscopy

A safe method of examining your Gastroitestinal tract. Guidelines recommend starting screening for colon cancer at age 45. This can be both diagnostic and therapeutic in identifying a variety of conditions such as

Colon Polyps

Colon Cancer

Rectal bleeding or positive blood in the stool

Diverticulosis and Diverticulitis

Diarrhea

Unexplained abdominal pain

Inflammatory bowel disease

Robotic umbilical/ventral hernia

Ventral hernias are any defects in the abdominal wall. Umbilical or Belly button hernias are quite common. A Hernia is a hole or weakness in the abdominal wall. It usually causes a visible bulge. Indications for repair include

Pain

Symptoms affecting lifestyle

Intestinal Obstruction

Hernia Incarceration

Strangulation of Hernia contents

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Robotic paraesophageal or hiatal hernia

A Hiatal Hernia occurs when a portion of the stomach slides into the chest cavity. Indications for repair include

Symptoms such as abdominal pain, chest pain, difficulty swallowing, reflux, difficulty breathing, vomiting blood, regurgitation of food, chronic cough

Blood loss anemia from ulcers

Barrett's Esophagitis, a condition caused by chronic reflux

Port Placement

A Port is a device implanted under the skin and has direct access to the venous system. This is performed under fluoroscopic and ultrasound guidance for adequate placement. Indications

Chemotherapy

Fluid infusions

Frequent blood Draws

Deliver medications, antibiotics, coagulation factors, and even chronic pain medications

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Soft Tissue Mass Excision

Soft tissue masses are lesions that sit under the skin or disrupt the skin, causing pain and discomfort. These lesions can be benign or malignant and require a physical examination or surgical removal to confirm their etiology. Examples include

Lipomas: fatty tissue deposits

Epidermal inclusion cyst: arises in areas of hair follicles

Ganglion cysts: arise from joints

Pilar cyst: typically occurs in the scalp

Hemorrhoid Treatment

Hemorrhoids are enlarging blood vessels which feel like a mass of the anus. They are common and, if untreated, can cause prolonged suffering. Hemorrhoids can be internal or external. Signs and symptoms include

Internal hemorrhoids cause bleeding or protrusion during bowel movements

External hemorrhoids are prone to cause pain or itchiness. Pain can sometimes be severe, leading to Thrombosed Hemorrhoids. These may need to be opened up in the office for relief.

We believe in a stepwise treatment approach to Hemorrhoids

Nonsurgical treatment: Including drinking water, limiting toilet time, avoiding straining during bowel movements, and laxatives such as Miralax

Surgical Treatment: includes rubber banding, coagulation, Hemorrhoidectomy

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Breast Cancer

Breast cancer Affects 1 in 8 women and is the most common malignancy in women in the United States. Diagnosis starts with a mammogram and a breast examination. This is usually followed by a breast biopsy for identification of breast cancer. Fortunately, most biopsies are normal. We believe in a multidisciplinary approach to breast cancer. Surgical treatment includes

Breast-conserving therapy or lumpectomy with Sentinel lymph node biopsy

Mastectomy with or without reconstruction

Bilateral Mastectomy

Skin Cancer

Skin cancer is the most common type of cancer. The main types of skin cancer are squamous cell carcinoma, basal cell carcinoma, and melanoma. Melanoma is much less common than the other types but much more likely to invade nearby tissue and spread to other parts of the body. Most deaths from skin cancer are caused by melanoma

Melanoma Excision with Sentinel Lymph node biopsy

Lymph node excision

Squamous Cell Carcinoma wide local excision

Abscess or Infection

Skin infections are very common and they often require drainage to achieve adequate source control to allow antibiotics to work. The area usually looks red, warm and filled with fluid. Prompt surgical intervention reduces pain and improves outcomes

Diagnostic Laparoscopy

Many conditions require a minimally invasive exploration of the abdomen to identify diseases that are not found on imaging. Such as