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
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
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
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
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
Abdominal pain
Scar tissue causing bowel obstructions
Infections
Liver biopsy
Laparoscopic feeding tube placement
Many conditions cause malnutrition, and access to the gastrointestinal tract is needed to optimize nutrition. Feeding tubes are typically placed in the stomach or small bowel