New method of surgery leaves patients virtually scar free
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Doctors at Mercy Hospital are able to perform surgery without actually touching the patient using the da Vinci surgical system.
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Only days after having gall bladder surgery performed with a DaVinci surgery system, patient Carri Kanehuebner's belly-button incision is well on it's way to being completely healed.
JANESVILLE — Gallbladder removal used to require an incision under the ribs big enough for the surgeon to reach in and pull out the organ.
Then came laparoscopic surgery, which requires four small incisions in the abdomen to remove the gallbladder.
Now, state-of-the-art technology allows the same organ to be removed through one small incision in the belly button, leaving a virtually invisible scar.
While 98 percent of gallbladder surgeries are done laparoscopically, Mercy Hospital and Trauma Center in June started doing single-site incision surgery using the da Vinci robot, said Dr. Patricia Garner, a general surgeon at Mercy.
The robot-assisted surgery through one incision allows for faster recovery, virtually no scarring and less pain, she said.
"Eventually, this will become the standard way of doing things," Garner said.
The U.S. Food and Drug Administration approved the procedure in February, so the medical community is just starting to see the benefits, she said.
Patti Ciardo, 53, Whitewater, was the first patient to have the procedure using the da Vinci Surgical Si HD dual-console system, which Mercy bought in 2009.
She was having abdominal pain, and her gallbladder wasn't properly processing bile. When Garner said she was training to do the surgery with the robot and told Ciardo she could be the first patient, she agreed.
"I said, 'OK, this could be really cool,'" she said.
She was a little apprehensive because it was her first major surgery, but she said it went well. She was off prescription pain medication after two or three days.
She's recovering well and said people wouldn't even know she had surgery.
"It's a lot easier than having to make a big incisions in your stomach like they used to," she said.
St. Mary's has a da Vinci robot at its Madison hospital, and two of the St. Mary's Janesville Hospital obstetrics and gynecology surgeons use the technology when appropriate, hospital spokeswoman Joan Neeno said.
"Given how expensive the equipment is, we want to be certain there is enough demand in Rock County to justify the cost of providing robotic surgery locally," she said in an email.
How it works
Gallbladder removal is the most common surgery for a general surgeon, Garner said. She once estimated she removes 150 gallbladders in a year, with many other general surgeons in the hospital doing the same thing. People need the organ removed either because they have gallstones or the organ isn't properly storing and processing bile from the liver to the small intestine.
In the new surgery, an incision is made in the belly button and a rubber port is inserted for a camera and three instruments.
Each of the three instruments is a hand of the robot, which Gardner controls with her fingertips at the console. The instruments have a greater range of motion—more than 360 degrees—than a surgeon's fingertips, Garner said.
"We're able to reach and turn and sew and do all kinds of different things," she said.
The three-dimensional view gives depth perception.
She's even told one of her patients, "I feel like my face is planted in your abdomen," she said. "That's what it feels like. The view is just worth it right there, then this extreme range of motion is even better."
To prevent the gallbladder from rupturing or spilling, it is placed inside a small bag inserted into the abdomen through a port, she said. The organ can be removed through an incision less than one inch long.
Carrie Kane-Huebner, 30, Janesville, already has recommended the surgery to a family member after her successful surgery June 14.
When doctors decided her gallbladder needed to be removed, her response to the single-site surgery was, "Sure, why not?" she said.
She slept for much of the first four days after surgery and ate soup and liquids. She was back to normal and returned to work after about 10 days, a shorter recovery period than the two weeks her friends needed after laparoscopic surgery.
She's still keeping her scar clean, and her belly button doesn't look exactly like it used to, she said. Garner was able to make the incision in a scar Kane-Huebner had from a former belly button piercing, then close it to eliminate the scar.
"You can't even tell that I had a surgery," Kane-Huebner said.
Jul 10, 2012 at 3:04 p.m.
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Sorry nicksmom read your post wrong.
Jul 10, 2012 at 1:43 p.m.
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I'm so glad we have people like nicksmom to tell us these these things instead of medical professionals. Want to tell me that my 4 week exercise restrictions were "excessive"?
Jul 10, 2012 at 1:35 p.m.
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10 days off work for robotic gallbladder surgery seems like an excessive amount of time off of work. My surgery was much more involved & I was back in the gym & at work within less than a week. Had I had traditional surgery the recovery would have been 6 weeks off work. Apparently many folks in Jtown don't care about technology, shorter recovery periods & patient centered care. What a shame.
Jul 10, 2012 at 12:16 p.m.
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10 days off work? Milking it a little?
jogging within a week... off work for 6 weeks
?????? How do you accuse someone of milking it and then make those statements?
Jul 10, 2012 at 11:53 a.m.
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I had my gallbladder removed with the da Vinci and had an amazing experience. I had the surgery on a Tuesday and was feeling better by the end of the week. The 4 incisions are almost invisible now. The only downside was not being cleared for exercise or lifting anything more than my baby for 4 weeks.
Jul 10, 2012 at 11:35 a.m.
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Belman,
Im sure you are aware that the Obamacare will also add costs to these types of procedures since Obama believes its necessary to tax med device company a 2.3% surcharge on sales. Med Device companies-like Medtronic or Intuitive Surgical will simply pass these taxes on as higher prices for the their products! Well done Obama!
Then again, if your idea of basic care is palliative care-or hospice you can choose do ignore medical advice and your individual costs may not increase-but I prefer choice. Imagine if you had the same opinion about peanut butter or bread or beer?
Jul 10, 2012 at 11:04 a.m.
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10 days off work? Milking it a little? I had a tumor removed from an ovary with the da Vacini and was back jogging within a week. Had I had traditional surgery I would have been hospitalized inpatient as opposed to outpatient & off work for 6 weeks. Unbelievable negative comments about robotic surgery. It's the best! Minimal scarring yes, but unbelievably quick recovery time.
Jul 10, 2012 at 10:40 a.m.
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Da Vinci robot was approved 12 years ago for general lap surgery-not in 2009. Mercy hospital can hardly be considered and early adopter of this technology. Robotic surgery is here to stay-even at Mercy. Competition for patients drive hospital systems to purchase this type of capital equipment. Today 85% of prostatectomies are performed robotically-as a patient the choice remains yours-have a tradition open prostatectomy or have it robotically? Good luck find a board certified urologist who would rather do the procedure open-if he/she can do it using the da Vinci. The question is-is it worth the cost? I'm sure if Obama himself were running Mercy, he would look at the 2.6 Million acquisition cost of 1 robot, the 200K in annual service costs, and the 1200-1500 in ancillary per procedure instrument costs and the fact that ISRG is a publicly traded company whose CEO is a 1% er and he would have decided-yes, Mercy needs to compete for patients just like any other hospital and Mercy needs to attract and retain surgeons who provide healthcare services for a fee-so the decision to buy a robot is an easy one.
Healthcare is a business and is not immune to competitive threats.
Jul 10, 2012 at 10:11 a.m.
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This is why health care cost more than any other country on earth.
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Because it is the best and fastest money can buy.
Jul 10, 2012 at 9:32 a.m.
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10 days till your back to work with this machine? I had mine taken out laproscopically on a Thursday and was back to work on Monday. Also, my scars are so faded that you can't even tell there were four incisions. Why don't they spend the money on a 3-D Tomosynthesis breast mammography machine. It would be much more worth the money.
Jul 10, 2012 at 8:33 a.m.
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My husband was diagnosed with kidney cancer in 2011 and had to have a part of his left kidney removed. Normally this would leave a massive scar and a very long lead time. He had the surgery using the Da Vinci robot which only left 6 port hole scars and the recovery time was cut in half. It is not just about the lastest and greatest gizzmo, the benefits of smaller incessions cut down on infections and with a recovery time cut down tremendously it actually helps the patients in the long run. I know from living it how much better it made my husband feel, which in turn made me very happy. We are happy to report we are cancer free!!
Jul 10, 2012 at 7:09 a.m.
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No, Mercy did not use that procedure before FDA approval. They have been using the Da Vinci to do other procedures, though laparoscopically with the 4 small incisions. The Da Vinci is used for more than just the single site incision. They used it for a prostatectomy when they first got it. Don't bash unless you know the truth. I am a Mercy employee and know that they do not do procedures unless approves, as there is a lot on the line.
Jul 10, 2012 at 3:08 a.m.
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The U.S. Food and Drug Administration approved the procedure in February, yet Patti Ciardo, 53, Whitewater, was the first patient to have the procedure using the da Vinci Surgical Si HD dual-console system, which Mercy bought in 2009. 2009?? So does this mean Mercy preformed the procedure prior to the FDA's approval? And why would Mercy shell out the huge amount to buy this 3 years prior to it being approved?
Maybe the Gazette could dig a little and find out what is actually going on, is Mercy preforming medical procedures before they are actually approved by the FDA? Experimental medicine brought to you by the fine folks at Mercy Health Systems, where price is no object when it comes to our new gadgets! Just be prepared to pay three to four times the amount of other regional health facilities.
Jul 9, 2012 at 5:08 p.m.
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This is why health care cost more than any other country on earth. This is not needed for basic care. Only because someone is worry about the looks they have. Does this make the cost cheaper Mercy. I tried to find out a cost for an office visit ( my congress man said I should shop smarter) Mercy refused to tell me. So much me shopping around. Tell me how to keep my cost down now Mercy.
Jul 9, 2012 at 5:08 p.m.
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This is why health care cost more than any other country on earth. This is not needed for basic care. Only because someone is worry about the looks they have. Does this make the cost cheaper Mercy. I tried to find out a cost for an office visit ( my congress man said I should shop smarter) Mercy refused to tell me. So much me shopping around. Tell me how to keep my cost down now Mercy.
Jul 9, 2012 at 4:59 p.m.
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Given the $1,000,000+ cost of a Da Vinci machine, are the outcomes significantly improved over the laparoscopic manner? Do patients recover faster? Are there fewer complications? In the overall, is it worth the money? The latest technology is sexy, but not necessarily better medicine, and it usually raises costs.
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