Robotic Gallbladder Surgery

IN HOUSTON, TX
It was not that long ago that patients undergoing gallbladder surgery were left with a sizable scar and an extensive time to recover. It required a large diagonal incision in the patient’s upper right abdomen. Today’s minimally invasive robotic gallbladder surgery requires four separate incisions, but these incisions are only about an inch in length.

The gallbladder resides behind the liver where it receives bile produced by the liver, which is released into the small intestine to aid in digestion. Gallbladder problems such as gallstones may result in the need for robotic-assisted removal which generally involves removal of the organ. However, advances in robotic gallbladder surgery have dramatically changed the way surgeons approach cholecystectomy. In keeping with his commitment to outstanding patient care, Dr. Harkins and his medical team have mastered the laparoscopic minimally invasive robotic-assisted gallbladder surgery.

Gallbladder Ailments Requiring Surgery

There are several common ailments of the gallbladder that require surgery. Dr. Harkins and his surgical team have mastered the minimally invasive robotic cholecystectomy or gallbladder removal, which is most commonly used to treat cholecystitis (inflammation or infection). Inflammation occurs if the bile duct is blocked, causing bile to build up resulting in painful swelling that can lead to infection. Swelling can also be the result of injury to the gallbladder. Patients may experience intermittent pain that over time becomes constant, resulting in robotic surgery. Not only is fever often present, a little over one-third of the patients presenting have a palpable gallbladder and about 15 percent of patients will have jaundice, which is yellowing of the skin.

Sometimes, Intensive Care Unit patients in the hospital develop acute acalculous cholecystitis, also known as porcelain gallbladder, which is the creation of thickened walls caused by calcification. Not only does this ailment give the gallbladder a white or porcelain appearance, but it also surrounds the gallbladder that can become distended, resulting in a need for robotic surgery. This medical condition is also seen in late term HIV patients, diabetics, and patients on total parenteral nutrition (TPN) for three months or longer. Patients suffering acute acalculous are at greater risk for perforation and/or gangrene. If the patient does not respond to intensive IV antibiotics and supportive therapies, the patient will need a robotic cholecystectomy. Robotic gallbladder surgery is recommended instead of using the traditional single cut to access the organ.

The single most common gallbladder disorder is cholelithiasis, also known as gallstones. These gallstones are thought to be created by cholesterol combining with bile salts and bilirubin (dead red blood cells), creating a small stone-like particle that can block bile ducts and cause severe pain. Being that treatment for gallstones is largely unsuccessful, the best approach for a commonly recommended cholecystectomy is robotic surgery.

Risk Factors for Gallbladder Disease

There are patients that are more prone to developing a gallbladder disease that leads to robotic gallbladder surgery and removal of the organ. Although it is unknown why certain risk factors occur, those in the following groups that are at a higher risk for developing a gallbladder disease requiring the da Vinci robot-assisted laparoscopic surgery include:

Women
Women who have been pregnant
Women over the age of 40
Women who are overweight

If you are concerned you may be experiencing symptoms of cholecystitis, call us immediately for a medical evaluation to determine if robotic gallbladder surgery is needed.

Symptoms for Gallbladder Disease

Sometimes a patient does not experience any discomfort, but there are common signs and symptoms that indicates one to have gallbladder disease, which include the following:

intermittent pain, particularly after eating, to occur on the right side
sharp pain that occurs because of swelling, resulting in cholecystitis
heartburn, indigestion, and vomiting
jaundice which indicates a blockage of the bile duct
fever may be present

When indicated, the patient will be referred to a robotic surgeon who will schedule a robot-assisted surgery.

Diagnosis and Treatment

A physician will order several tests to assist in diagnosing and treating cholecystitis, acute acalculous cholecystitis, and cholelithiasis. These will include blood tests, sonograms, CT scans or MRIs may be ordered. Although treatment with IV antibiotics and other medications is possible, the success of these treatments is low. The most effective way to treat these disorders is through a cholecystectomy using robotic surgery, so it is typical for doctors to refer their patients directly to a surgeon when gallbladder disorders are discovered. Patients need to be seen quickly to get their da Vinci Xi robotic surgery scheduled before other complications set in that could make single wound open gallbladder removal surgery using a single incision the only option.

What to Expect During a Cholecystectomy

There are two medical surgical procedures used to remove the gallbladder: single wound open surgery and laparoscopic robotic surgery. Although laparoscopic surgery is most commonly performed, there are surgeons who prefer the open single cut surgery approach to remove the organ using a single incision that can be as long as seven inches. The open method is also used when a patient presents with abnormalities that make laparoscopic surgical procedures impossible.

Surgeons who use this method make the single incision and then spread open the skin, clamping it back so the liver can be lifted and the organ accessed. The surgeon clips and cuts the bile duct, along with the blood vessels that feed the organ, then the surgeon is able to carefully remove it. Surgery may involve special x-rays called cholangiograms, using dye injected into the common bile duct to ensure there are no gallstones present in the bile duct or abdomen. Recovering from the removal of the gallbladder, which takes about one to two hours, normally means a five-day stay in the hospital and then weeks before patients can lift a considerable weight.

Robotic Laparoscopic Surgery

The best laparoscopic robot-assisted surgical tool is the latest model, da Vinci Xi. The da Vinci Xi model allows more control over robotic gallbladder surgery with a camera that provides superior imaging and specialized surgery tools allowing for precise removal. The robotic gallbladder surgery uses four small incisions about one-half inch in length. During surgery, the patient’s abdomen is filled with gas to allow easier access to the organs and better visuals. The surgeon then completes the robotic gallbladder surgery by gently detaching the organ and removing it through one of the ports. This robotic surgery is safe and only 2 percent of surgeries performed using this method result in a complication.

Advantages of Robotic Gallbladder Surgery

There are many advantages the robotic da Vinci Xi has over open surgery. For instance, patients having the robot-assisted surgical removal of their gallbladder experience much faster recovery time than those receiving an open single incision cholecystectomy. Many patients are able to go home the same day as their robotic surgery, but there are others that need an overnight stay. As soon as a normal diet can be tolerated after robotic gallbladder surgery is completed, the patient is discharged, which is much faster than with single incision. In addition, patients are able to remove their bandages (not Steri-strips), bathe the very next day and resume regular activities in as little as five days to one week after robotic surgery.

The impact of robotic gallbladder surgery compared to single incision surgery is leading surgeons to become proficient in robotic cholecystectomy surgery. The da Vinci Xi robot is rapidly becoming the most advanced tool in robotic cholecystectomy surgery and hands down superior to the single incision method that results in longer recovery time. Not only are the advantages of robotic control clear, but patients and surgeons also prefer robotic gallbladder surgery.

Dr. Brian Harkins is here to provide the very best care, performing robotic gallbladder surgery with delicate precision. His patient’s comfort is of the utmost importance which is why he opts to use the latest equipment, the da Vinci Xi. Dr. Harkins understands that having surgery is inconvenient and getting back to regular activities quickly after robotic surgery is vitally important to his patients. By mastering the da Vinci Xi assisted robotic surgery techniques, Dr. Harkins has ensured his patients will receive the absolute best patient care possible in today’s robotic surgery procedures.

Robotic Gallbladder Surgery

To schedule a consultation with Dr. Harkins to discuss robotic gallbladder surgery, call 281-351-5409 or fill out the online form and get started today on the road to recovery. Dr. Harkins and his team are available in the office Monday thru Friday and are on call 24/7.