Surgery To Go

Women today are far too busy to take the time off to recover from surgery thus put it off, at times, risking their health or even their life. Although we are not quite ready for drive-thru surgical rooms, we are minimizing recovery time from weeks to days with minimally invasive surgery and high tech robotics.

Story: Maritza Manresa

What was your immediate reaction when the doctor told you that you needed to have your gallbladder removed or that your endometriosis could no longer be ignored? More than likely, it was something to the effect that you just do not have the time for that. Most women today have such hectic schedules which, simply put, they just cannot fit extended downtime following a surgical procedure. Well, that is not the case anymore. Not just for gall bladder removal surgery or taking care of endometriosis, but also for many other procedures that in the past required considerable recuperating time. Those same procedures can now be done and have you back to your routine within a couple of days rather than weeks. Today, doctors are opting, when at all possible, to do minimally invasive surgery, also known as laparoscopic surgery. Laparoscopic surgery could either be hand assisted laparoscopic surgery or robotic assisted laparoscopic surgery as it is the case with the daVinci Surgical System robot.

Hand assisted laparoscopic surgery consists of inflating or opening the abdominal wall separating it from the internal organs, thereby creating greater space in which to work. Then several small incisions are made – approximately half to one inch long in the abdominal area, through which the special surgical tools are inserted to perform the surgery. A scope with a video camera is also inserted through a small incision by the belly button, which allows the doctor to see inside the body, with extreme clarity, on a TV monitor. There are multiple surgical procedures that can now be done by laparoscopic surgery, however, some of the most common procedures done by hand assisted laparoscopic surgery include: appendix removal, gallbladder removal, hiatal hernia repair, and multiple bariatric procedures such as gastric bypass, gastric band placement, sleeve gastrectomy.

The health benefits of bariatric surgery immensely surpass the benefits of a better physical appearance. Yet, a large number of people do not undergo this type of surgery because of the extensive downtime associated with it. However, with minimally invasive bariatric surgery, patients can go about their daily lives much quicker than with conventional surgery. The procedure does not require cutting inside the belly or using staples, allowing patients to be discharged from the hospital within a few days of surgery and back to their daily routines in half the time it would take with conventional procedures. One of the most common procedures is the gastric bypass which makes the stomach smaller and causes food to bypass part of the small intestine. Another procedure, which can be done laparoscopically, is the gastric band placement. This procedure consists of the surgeon placing a band around the upper part of your stomach to separate it from the lower part, thereby creating a small pouch with a narrow opening that goes into the lower part of your stomach. Lastly, a third procedure that can be done by laparoscopic surgery is the sleeve gastrectomy which is a procedure whereby the size of your stomach is reduced to approximately the size of a banana. This is accomplished by creating a thin vertical sleeve using a stapling device and removing the excised portion of the stomach through a small two inch incision.

In addition, considering how studies have shown that seventy five percent of all gallbladder removal surgeries are done on women, minimal scaring and quick recovery are two of the top reasons to go this route. A laparoscopic gallbladder removal can be accomplished by making several small incisions through which the special surgical tools are fed to remove the gallbladder thereby avoiding the large incisions that otherwise would have been made with conventional surgery, along with eliminating the extended hospital stay and reducing downtime after surgery. Also, repairing a hiatal hernia is much simpler with such minimally invasive surgeries since the hernia can actually be repaired, once again, through very small incisions, requiring possibly a one night stay in the hospital.

On the other hand, unlike hand assisted laparoscopic surgery where the surgeon manually conducts the surgery, with robotic assisted laparoscopic surgery the surgeon works on the patient by manipulating robotic equipment from a computer console a few feet away from the patient. The daVinci surgical robot allows the surgeon to operate with tremendous control, precision, and dexterity as well as great visual clarity. The robotic system has a 3D HD camera, giving the surgeon the most clear view of the operating area -- as if they were looking straight into the inside of the person’s body. Robotic assisted surgery is the least invasive surgery option, and yet the most effective. Using the daVinci surgical robot, the surgeons experience added flexion and extension so that they can better manipulate the surgical instruments. Thus, the added range of motion increases the surgeons’ ability to do more internally than with hand assisted laparoscopic surgery. Ultimately, the procedures require only a few small incisions, resulting in less blood loss, less trauma, decreased likelihood of developing infections, and much shorter recovery time. Robotic assisted laparoscopic surgeries are being used in many different sectors of the medical field such as in urology, cardiac, colorectal, general, thoracic, and gynecology.

Especially in the gynecological field, great strides have been made in turning what used to be physically traumatic surgical procedures to surgeries that can be performed through few small incisions -- even prolapse surgery which normally requires a long incision in the lower abdomen resulting in a prolonged recuperating period. Other robotic-assisted gynecological surgical procedures include the removal of uterine fibroids and the reconstruction of the uterine wall.
The many advantages of undergoing minimally invasive surgery will certainly help any surgery candidate reconsider not going through the procedure due to lack of time to recuperate. Whether you are a stay at home mom or a busy career woman, time always seems to be of the essence and sitting around waiting to feel better before being able to tackle your next task, is just not feasible.

Medical information for this story was provided by Dr. Lawrence McChesney, Ocala Health System Surgical Group, Dr. Salvador Ramos II, Central Florida Surgical Services, and Dr. Anthony DeIorio, Ocala Surgical Associates.