MedStar Montgomery Medical Center offers the best of both worlds: advanced healthcare technology combined with the feeling of a community hospital. Now, with the da Vinci® Si™ Surgical System, the latest version of the world's most advanced robotic surgery system, our surgeons have the advantage when performing minimally invasive surgery for the treatment of a wide range of conditions, including some types of cancer.
Plus, with the recent addition of Single-Site™ da Vinci technology, we are among the first hospitals in this region to be able to perform certain surgeries through a single incision as small as an inch. This advanced surgical technique was recently approved by the Food and Drug Administration specifically for cholecystectomy procedures, the removal of the gallbladder.
The goal of any surgery is to treat the problem and sometimes a robotic procedure is the best course of action. At MedStar Health, our skilled surgeons are leading the way in robotic surgeries. Trained extensively with the latest generation of robotic surgery systems, we are applying the procedure to more and more specialties.
The types of robotic surgery offered by MedStar Health include:
- Bariatric Robotic Surgery
- Colorectal Robotic Surgery
- Gynecologic Robotic Surgery
- Head and Neck Robotic Surgery
- Thoracic Robotic Surgery
- Prostate Robotic Surgery
- Urological Robotic Surgery
The da Vinci® surgical robot system makes this innovative offering a possibility. Learn more about some of our specialized robotic surgery procedures:
- Robotic-Assisted Cystectomy (RARC)
- Robotic-Assisted Laparoscopic Pyeloplasty
- Transoral Robotic Surgery (TORS)
- Video-Assisted Thoracic Surgery (VATS)
Robotic-Assisted Cystectomy (RARC)
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. Using this method, the surgeon is able 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.
Robotic-Assisted Laparoscopic Pyeloplasty
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. It is used to treat ureteropelvic junction (UPJ) obstruction, a condition where a blockage occurs at the junction where the pelvis and ureter meet.
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.
This is a minimally-invasive procedure that is as safe and effective as open surgery pyeloplasty, while providing the patient with less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, and smaller incisions.
Transoral Robotic Surgery (TORS)
MedStar Health is one of the few health systems in the region performing transoral robotic surgery (TORS) for head and neck cancers and obstructive sleep apnea. Most TORS procedures are performed for tumors of the oropharynx, which includes the soft palate, the base of the tongue, and the tonsils. TORS may also be potentially used for tumors of the supraglottis, the area above the vocal cords, and hypopharynx, the area next to the voice box.
There are many advantages to undergoing TORS for treatment these tumors rather than a traditional, open procedure. These benefits include:
- Easier access. In the past, surgeons needed to perform radical surgery by making a large incision in the face and splitting the mandible (jawbone) to access tumors of the tonsil and tongue base. During TORS, doctors can access that hard-to-reach area through the mouth.
- No visible scars or disfigurement. TORS surgery is performed entirely through the mouth, so there are no visible scars. For patients with cancer, a second surgery may be required to remove lymph nodes in the neck, and this does require a neck skin incision, but the scar is minimal.
- Shorter hospital stay. Patients generally leave the hospital two to four days after a TORS procedure. Following traditional surgery, the hospital stay is typically longer than a week.
- Improved speech. Speech function is outstanding after TORS, with nearly all patients recovering normal speech. In contrast, impaired speech function is common following a traditional surgery.
- Minimization or elimination of need for chemoradiation therapy.
The advantages of undergoing TORS for these tumors rather than receiving up front chemotherapy and radiation treatment include:
- Improved swallow function. When patients undergo TORS to remove tumors, the long term feeding tube dependency rate is as low as zero to four percent. After combined radiation therapy and chemotherapy treatment for the same type of tumors, long term feeding tube dependency is as high as 20 to 30 percent.
- Lower dose of radiation. Patients who need radiation therapy after a robotic surgery generally need a lower dose of radiation than individuals receiving radiation treatment as primary treatment. This results in decreased side effects from the radiation therapy such as dry mouth, trouble swallowing, loss of taste, and pain.
- Possible avoidance of chemotherapy. In most cases, patients who undergo TORS do not require any treatment with chemotherapy after surgery.
TORS for Obstructive Sleep Apnea
TORS for obstructive sleep apnea (OSA) is a new approach to treating this disorder. One possible cause of OSA is excessive tongue base tissue which can fall backward during sleep, obstructing the airway. Additional possible causes are excessive soft palate tissue, or enlarged tonsils that block flow of air when sleeping. One of the treatment options for OSA is to remove the excess tissue, which can be difficult to do through traditional surgical methods.
During a robotic procedure, the surgeon has an unparalleled view of the operating field. Due to the dexterity of the robotic instruments, the surgeon can access and remove the obstructing tissue in locations where traditional approaches have difficulty.
Video-Assisted Thoracic Surgery (VATS)
Robotic surgery for thoracic conditions is a new and exciting field. Until recently, surgeons used open surgical techniques to treat all thoracic conditions, which meant opening the chest and splitting the breastbone.
Now, surgeons can perform a variety of chest surgeries using a video-assisted thoracic surgery (VATS), which uses smaller incisions, leading to a faster, easier recovery, and less risk of infection. The robot's enhanced visualization leads to a more precise surgery than an open approach.
During this procedure, your surgeon uses a video camera to get an enhanced view of the structures inside the chest. Surgeons also use robotic VATS for lobectomy and lymph node dissection as a way to stage lung cancer and determine whether or not it has spread throughout the body.
Traditional VATS and robotic VATS are both minimally-invasive procedures, however the benefits of a robotic VATS procedure over traditional VATS include:
- Superior visualization. A regular VATS monitor is 2-D. A robotic VATS enables your surgeon to see the operating field in 3-D, providing critical depth perception.
- Precise dissection. Your surgeon can see the affected area much more clearly. The superior dexterity of the robotic instruments allows for a more precise dissection of the lymph nodes.
- Reduced risk of infection and faster recovery. Since your surgeon did not open your chest, there are fewer traumas to your body. This lowers your chances of infection and speeds your recovery.