When medication and other non-surgical treatments are unavailable or cannot relieve symptoms, surgery is the recommended treatment for many urologic. Our surgeons have the training and expertise to perform the most complex urologic conditions including:
- Kidney cancer (partial nephrectomy)
- Ureteropelvic junction (UPJ) obstruction
- Bladder cancer (radical cystectomy)
- Vesicoureteral reflux
Robotic-assisted laparoscopic partial nephrectomy provides patients with a safe and effective way to remove small renal tumors while preserving surrounding kidney tissue. This minimally-invasive technique leaves patients with less discomfort and comparable results when compared to traditional surgery. Additionally, the robotic platform gives the surgeon more freedom of movement and a magnified view that allows for more precise dissection. Patients undergoing robotic-assisted and laparoscopic surgery have significantly less post-operative pain, shorter hospital stays, earlier return to daily activities, and smaller incisions.
Partial nephrectomy is the preferable approach for patients with small renal tumors (less than 4cm). However, some tumors that are deep within the kidney or close to the kidney's blood supply may not be amenable to partial nephrectomy. Additionally, larger tumors (>4-7cm) can sometimes be treated with partial nephrectomy, but may often require complete nephrectomy depending on the location of the tumor.
Using a near-infrared camera and a benign tracer that is injected into the blood, surgeons are able to see the blood supply to the kidney and tumor as well as differentiate cancerous from normal kidney tissue. This enables better control of the kidney's blood supply, potentially less injury to the surrounding kidney, and limits the risk of leaving any tumor behind.
Ureteropelvic Junction (UPJ) Obstruction
Robotic-assisted laparoscopic pyeloplasty is a surgery that repairs congenital or acquired narrowing or scarring where the ureter (the tube that drains urine from the kidney to the bladder) attaches to the kidney. This is a minimally-invasive procedure that is as safe and effective as the open surgery, while providing the patient with less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, and smaller incisions.
The abnormality that is repaired is called a ureteropelvic junction (UPJ) obstruction. Over time, obstruction of urine drainage from the kidney by a UPJ obstruction can result in abdominal and flank pain, nausea and vomiting, kidney stones, urinary tract infection, high blood pressure, and even deterioration of kidney function. During pyeloplasty, this obstruction is removed, and the normal parts of the kidney and ureter are sewn back together.
Not long ago, all cystectomies were performed using an open surgical procedure in which notable tissue and nerve damage, significant blood loss, and an increased risk of post-operative infections and complications were common. Robotic cystectomy is simply a minimally invasive surgical method for bladder cancer. This procedure offers bladder cancer patients the prospect of a more effective surgery and less problematic post-surgical recovery. This surgical procedure allows the surgeon to make smaller incisions which spare vital, but delicate, nerve and muscle tissue. The patient experiences a shorter hospital stay, fewer complications, and a faster recovery time.
Similar to a standard laparoscopic cystectomy, the robotic-assisted cystectomy may require a urinary diversion with subsequent reconstruction for the removed bladder. For men and women alike, such reconstruction would include a continence reservoir which holds urine in the abdominal cavity until the patient has been fitted with a catheter to empty urine or a bladder replacement and an external bag for urine collection.
By offering the surgeon, urologist or oncologist a high-definition 3-D view, the da Vinci surgical robot distinguishes the vital muscles and delicate nerve tissues surrounding the operative area, providing the opportunity to preserve them. The robot's unique EndoWrist instruments offer physicians the dexterity not available to them when using conventional laparoscopic instruments. By taking advantage of the da Vinci robot, surgeons are able to dissect and reconstruct the bladder with relative ease.
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Robotic Surgery at MedStar Georgetown
At the cornerstone of robotic surgery is the da Vinci ® Surgical System–a sophisticated platform designed to expand the surgeon's capabilities. If you or a loved one has been diagnosed with a condition that may require surgery, you owe it to yourself to learn about all of your medical options, including one of the most effective, least invasive surgical treatments, robotic surgery.