da Vinci® Single-Site®Gallbladder Removal

If you have develop gallbladder symptoms, you may require an operation to remove the gallbladder. It's an organ you can live without. Gallbladder removal is known as a cholecystectomy. Historically, this was done through a long incision under the right rib cage (so called "open cholecystectomy"), requiring hospitalization for several days for recovery. In 1991, laparoscopy revolutionized the way this surgery was done, so that the gallbladder would be removed using 4 puncture sites, simplifying recovery into a day surgery instead.

Brooks Web

Instead of four puncture sites, gallbladder surgery is now possible using one puncture site at the umbilicus: using the da Vinci robotic platform. In early 2014, Dr Loewen was the first surgeon on Cape Cod to start performing gallbladder surgery using this technique and now does these routinely.

How does it work?

The da Vinci Si Single-Site System uses state-of-the art robotic and computer technologies. Instead of four instruments going through four separate puncture sites, all four instruments fit through the same puncture site. In order for this to work, the instruments and ports (through which the instruments are placed) are placed into a single gel type port and docked (connected) to the robotic arms, arranged in a very specific configuration:

Brooks Web

Seated a few feet away from the patient, Dr. Loewen controls every movement of the da Vinci Single-Site System, viewing a magnified, high-resolution 3D image of the surgical site. To operate, Dr. Loewen moves master controls that look like forceps. In real-time, the system translates each hand movement into precise micro-movements by the da Vinci miniaturized instruments attached to the robotic arms. Using the system's autonomous camera control, Dr. Loewen can safely remove the gallbladder through the belly button in a single incision of approximately one inch.

Why da Vinci Single Site Surgery?

The da Vinci System features a magnified 3D high-definition vision system coupled with flexible Single-Site instruments. These features enable your doctor to operate with enhanced vision and precision.

With da Vinci Single-Site Surgery, your gallbladder is removed through a single small incision in your belly button similar to traditional single-port laparoscopy. Patients who choose da Vinci Single-Site Surgery experience virtually scarless results.

As a result of da Vinci technology, da Vinci Single-Site Cholecystectomy offers the following potential benefits:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Low blood loss
  • Short hospital stay
  • Virtually scarless results
  • High patient satisfaction
  • Minimal pain

The da Vinci Surgical System offers the latest in surgical and robotics technologies. Dr Loewen is 100% in control of the da Vinci System, which translates his hand movements into smaller, more precise movements of tiny instruments inside your body.

Question / Answer

Q: How many surgery assistants are require for this surgery?

A: The single site robotic cholecystectomy requires one surgical assistant to exchange instruments and to retract on the assistant port - this is the grasper (instrument) that pulls on the fundus of the gallbladder.

Q: Is the internal procedure for this operation different from the laparoscopic procedure?

A: The procedure is nearly identical. The basic components to the surgery are exposure, dissection of the duct and artery, division of the duct and artery, dissection of the gallbladder, and extraction. The instrument tips are nearly identical, and the time that it takes to do each component of the surgery is very similar. One minor difference is the clip used, which is a plastic locking clip for the robotic procedure, compared with a titanium one for the laparoscopic.

Q: Does the gallbladder removal take longer using the robot?

A: It is true that set-up time (before the patient is brought back to the operating room) is a few minutes longer, but operating time is not much different than a laparoscopic surgery. Each takes roughly an hour to complete.

Links

di Vinci
JAMA feasibility article (2011)

< Back to list of physicians