The da Vinci Single Port
Laparoscopic Cholecystectomy
Brent Wogahn, MD
General & Vascular Surgery
Evergreen Surgical
Eau Claire
A cholecystectomy is the medical term used to describe the removal of the gallbladder. In the United States, typically 500,000 to 600,000 gallbladders are removed each year with about 90% of them being done laparoscopically.
The da Vinci robotic system made by Intuitive
Surgical was first approved by the Food and Drug Administration in 2000 for use in surgery. Initial procedures that were targeted by the company were uterus and prostate removals. Use by general surgeons for cholecystectomies has been slow to gain acceptance. Recently, there has been a development that may change your surgeon’s outlook on using the da Vinci Surgical System.
Typical laparoscopic surgery involves three to four small incisions. The idea to reduce the number of incisions down to one slightly larger, hidden in the umbilicus (belly button) has been around for about a decade now. However, it has not been gaining wide acceptance. The reason for this is that the procedure required different instruments and a slightly changed viewpoint of the television camera that the surgeon sees. The surgeon was required to operate with crossed arms in order to make the right hand
move the right instrument and the left hand move the left instrument. The single port size required the operating instruments to cross in the port in order to provide enough motion for the surgeon to operate. This turned the operation into a challenging game of twister.
The da Vinci robot changes all of that. The robotic arms are attached to the surgical instruments that best fit the robot. Your surgeon then works at the nearby console with full control of the arms. The computer does the arm crossing for the surgeon and thus the movement of the right arm on the screen is controlled by the surgeon’s right hand and vice versa. The surgeon also has stereoscopic three dimensional vision for the procedure, rather than the commonly used monocular two dimensional camera that is widely used today.
I have been doing surgery via the da Vinci Surgical System for the past three years. The main focus for me has been on cholecystectomies. Initially, the surgery was done using the typical multiport layout. For the past year I have been using the specially designed surgical instruments and the single port on selected patients with great success. The patients have been happy with the cosmetic results and with only having to deal with the postoperative pain from one incision instead of four. The single port surgery is currently not for everyone. However, just as our experience with laparoscopic surgery over the last three decades, I believe more and more people will become candidates for the single port surgery in the future.
Dr. Brent Wogahn–Southside OB-GYN
For information or to schedule an appointment:
715-832-1044 | www.evergreensurgical.com
Dr. Wogahn sees patients in Eau Claire and Durand.
