03/07/2013

Surgeon First in NH to Remove Gallbladder Through Belly Button Incision

A surgical team at Wentworth-Douglass Hospital performed the first da Vinci® Single-Site™ Cholecystectomy in New Hampshire in February. The patient’s gallbladder was removed through one tiny incision in the belly button, making the procedure virtually scarless.

Led by Patricia Auty, MD, the team removed the gallbladder using Single-Site™ instruments on a da Vinci® System. The minimally invasive procedure is traditionally called a laparoscopic cholecystectomy (removal of the gallbladder). The standard laparoscopic cholecystectomy uses 3 to 5 small incisions to remove the gallbladder. Single incision laparoscopic gallbladder removal has also been conducted in the past but is difficult to perform, often adding time to the length of the procedure. Thus, single incision laparoscopic cholecystectomy has largely been abandoned. Using Single-Site™ robotic assistance, surgeons are able remove the gallbladder through an incision of approximately one inch without adding to the length of the procedure. 

The Food and Drug Administration cleared the specialized Single-Site instruments for use with the da Vinci System in December 2011. da Vinci is a robotic surgical system widely used in complex minimally invasive surgery. Patients should discuss all the specific risks and benefits of robotics with their provider before electing to proceed.

Robotic surgery and single-incision surgery are not new, but combining the two to remove the gallbladder requires additional training and special equipment. 

“When the single incision procedure is performed robotically, the ease and precision is enhanced over laparoscopic methods due to the state of the art instrumentation that the Da Vinci System provides," says Dr. Auty. "To be the first hospital in New Hampshire and one of the first in Northern New England to offer this technically advanced surgery demonstrates Wentworth-Douglass’ leadership in providing patients with the most advanced options for minimally invasive surgery." 

Dr. Auty is one of a small group of surgeons in the country who has received training to perform the surgery.

“Robotic surgery is an exponential advancement in minimally invasive techniques,“ Dr. Auty said. “With the da Vinci Single-Site system we can offer tomorrow’s technology today at Wentworth-Douglass Hospital.” 

Potential benefits of Single-Site gallbladder surgery may include virtually scarless results, minimal pain, low blood loss, fast recovery, a short hospital stay and high patient satisfaction. The surgery can be performed in about one hour with a typical hospital stay of less than 24 hours.

During the procedure, the surgeon sits comfortably at a console, viewing a 3D, high-definition image of the patient’s anatomy. The surgeon uses controls below the viewer to move the instrument arms and camera. In real-time, the system translates the surgeon's hand, wrist and finger movements into more precise movements of the miniaturized instruments inside the patient. Unlike traditional robotic surgeries requiring three to five small incisions, this new technology allows for a single incision in the belly button where instruments are placed and the diseased gallbladder is removed.

Most people who require gallbladder removal are candidates for the robotic, single-incision surgery. According to the American College of Surgeons, surgery is the recommended treatment for gallbladder pain from gallstones and non-functioning gallbladders. More than 1 million people in the U.S. have their gallbladder removed each year. Most are performed with traditional laparoscopy using several incisions.

In addition to gallbladder removal, Wentworth-Douglass surgeons perform other general surgery procedures. Dr. Auty said, “We are very excited about the new Single-Site technology we now offer robotically and proud to provide a variety of other general surgery, robotic intra-abdominal procedures including advanced colorectal procedures. 

Wentworth-Douglass also offers robotic-assisted surgery in Gynecology and Urology, as well as General Surgery procedures.
Wentworth-Douglass also offers a wide range of minimally invasive conventional laparoscopic surgeries.