This article originally appeared in Connections, a magazine
published for physicians and the community by UMass Memorial Medical
Center.
Surgeons at the hospitals of UMass Memorial Health Care perform more than
40,000 surgeries each year, many with minimally invasive techniques that offer
patients smaller incisions, shorter hospital stays and faster recovery, as well
as less postoperative pain and improved outcomes.
UMass Memorial
Medical Center is the first academic medical center in New England to offer
robotic surgical services across four cancer specialties: urologic, gynecologic,
thoracic and gastrointestinal. Our surgeons use the robotic daVinci S Surgical
System, which provides a clearer view of the surgical site and controls that
allow the surgeon greater dexterity and precision than when using his/her hands
alone.
Colon and rectal surgeon Paul Sturrock, MD, recently performed a procedure
with daVinci to treat early rectal cancer with no need for chemotherapy or
radiation.
"Using the daVinci system provides enhanced visualization of the pelvic floor
for more precise dissection," said Dr. Sturrock. "The robotic arms are able to
articulate deep into the pelvis to allow fine movements, while preserving a
magnified, three-dimensional view. In cases where suturing is required, the
robotic arms allow for more exact suture placement and intracorporeal
knot-tying."
The technique appears to be most beneficial in rectal cancer resection cases
and as an abdominal approach to rectal prolapse repair, according to Dr.
Sturrock.
daVinci is also available at UMass Memorial to a growing number of women as a
minimally invasive alternative to open surgery for hysterectomy and cervical and
uterine cancers, as well as uterine fibroids, endometriosis and pelvic organ
prolapse.
"I treat all my endometrial cancer patients robotically, using it for
hysterectomy and staging," said gynecologic oncologist Antonella Leary, MD. "The
only patients I exclude are those with significant cardiopulmonary disease who
cannot withstand the Trendelenburg position or those who cannot tolerate having
their abdomen insufflated.
"I have even used the robotic procedure in patients with a BMI of 60," Dr.
Leary added. "In fact, larger patients often benefit most because they come out
with a very small incision, so the likelihood of it separating is very low
versus a larger incision with open surgery."
The robotic technique confers significant benefits to her patients, according
to Dr. Leary. "My patients go home the next day, they're back on their feet
within a week, and back to work within two to three weeks," she noted. "Plus,
most of my patients take post-op pain medication for maybe two days; with the
open approach, they're on pain meds a lot longer."
Gallbladder removal through single port laparoscopy
Hongyi Cui, MD, PhD, associate director of the acute care surgery service at
UMass Memorial Medical Center, is performing innovative minimally invasive
surgery for patients with gallbladder diseases. The procedure, called single
port laparoscopic cholecystectomy, leaves patients with one small scar hidden in
the belly button versus the typical four scars in the abdomen resulting from
standard laparoscopic removal.
"Patients typically go home the same day as the surgery and are returning to
work sooner with reduced down time for recovery. The most striking difference is
that virtually no scar can be seen several weeks after surgery," said Dr.
Cui.
Dr. Cui was the first surgeon in Central Massachusetts to perform this novel
minimally invasive approach to gallbladder surgery. Since May 2009, he has
performed numerous gallbladder removals without complications.
"The single-incision laparoscopic surgery is more technically challenging
than a conventional laparoscopic procedure and it requires more advanced
surgical instruments," Dr. Cui noted, adding, "Nationwide, this technique is
available in only a limited number of hospitals, including our Medical
Center.
"This technique may potentially replace multi-port techniques and bring
minimally invasive surgery into the future much more quickly," Dr. Cui
added.
He used the single port method to remove Katie McCormick's gallbladder. "Dr.
Cui told me that the surgery would result in a quicker recovery, which was
important to me because I live in Europe and also had a vacation scheduled in
two weeks," Ms. McCormick said. "Almost exactly two weeks after my surgery, Dr.
Cui gave the okay to travel, as long as I napped, relaxed and didn't lift
anything. I have had no issues since."
Dr. Cui has also removed appendixes using the single port technique. "These
patients had no complications. They are very happy. This is exciting for many of
my patients who care about their body image." Dr. Cui noted that the procedure
is not for obese patients or for cancer patients.
Appointments:
Colorectal cancer: 866-597-HOPE (4673)
Gynecologic
cancer: 866-597-HOPE (4673)
Gallbladder removal: 508-334-0545