In what could have passed as science fiction a few years ago, a surgeon at the Medical Center of Trinity has performed the first gallbladder removal in Pasco and North Pinellas using robotic technology and just a single incision.
The single-site cholecystectomy, or gallbladder removal, uses a robotic tool called the da Vinci Surgical System, which gives patients a more comfortable, virtually painless procedure that leaves minimal scarring.
General surgeon Keith Chisholm has now done more than 20 of these surgeries with the aid of the $1.8 million robot. During the surgery, doctors view a magnified, three-dimensional image of the surgical site while sitting at a console next to the patient. The doctor controls four robotic arms that extend and enhance his ability to maneuver in smaller spaces.
The hospital had the first generation of the robotic system when it was at its former location, on Marine Parkway, and was known as Community Hospital of New Port Richey, Chisholm said. Since relocating to Trinity, the hospital has purchased da Vinci's third-generation system.
"There's a little mystique about using a robot to do surgery," Chisholm said. "Really the only difference in robotic surgery versus laparoscopic is instead of me and an assistant using the instruments with our combined forehands, the robot and its arms grab the instruments and allows me to control all four."
Traditionally called a laparoscopic cholecystectomy, the now minimally invasive robotic procedure combines the technology of the da Vinci System with a single incision through the patient's belly button.
"Unlike traditional robotic surgeries requiring three to five small incisions, this new technology allows for a single incision in the belly button, where instruments are placed and the diseased gallbladder is removed," said Chisholm, who uses the da Vinci surgical system for other surgical procedures.
"This single-site incision is approximately one inch long and allows patients the benefits of minimally invasive surgery; typically less bleeding, less pain and a quicker return to activities, with almost no visible scar," Chisholm said.
Most people who require gallbladder removal are candidates for the robotic, single-incision surgery. According to the American College of Surgeons, surgery is the recommended treatment for gallbladder pain from gallstones and nonfunctioning gallbladders.
"The magnification and three-dimensional optics of this surgical system, along with added dexterity using the special instruments, help the physician perform the operation in a safe, efficient manner," Chisholm said. "Patients are pleased with both the ease of their physical recovery and the fact that they aren't left with large scars."
Prior to the robotic single-site cholecystectomy, gallbladder surgery required several incisions, which left patients to face longer recoveries and more scars.
Chisholm used to be a skeptic about robotic surgery but now he's a believer. General surgery has been one of the last departments to pick up on robotic technology, with urology, obstetrics and gynecology in the vanguard. Although he thinks robotic surgery will become more widespread in the future, he doesn't think it will be any time soon.
"I don't think it will ever be used by everyone because the robot is pretty expensive," Chisholm said. "It does take a lot of training; it takes me months to get to this point. It will certainly become more widespread, but that will be years in the future."