Robot-Assisted Laparoscopic Procedures
Definition
| Laparoscopic Cholecystectomy |
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| Close-up view of laparoscopic tools used to remove the gallbladder (green structure). |
| Copyright © Nucleus Medical Media, Inc. |
Reasons for Procedure
- Adrenalectomy —removal of adrenal gland
- Appendectomy —removal of the appendix
- Bariatric surgery —surgery of the stomach to treat obesity
- Cholecystectomy —removal of the gallbladder
- Colorectal procedures
- Hernia repair
- Nephrectomy —removal of a kidney
- Nissen fundoplication —surgical reinforcement of the valve between the esophagus and stomach
- Prostatectomy —removal of the prostate
- Hysterectomy —removal of the uterus (results in infertility)
- Myomectomy —removal of fibroids (noncancerous tumors in the walls of the uterus)
- Less scarring
- Reduced recovery times
- Less risk of infection
- Less blood loss
- Reduced trauma to the body
- Shorter hospital stay
- Faster recovery
Possible Complications
- Damage to neighboring organs or structures
- Infection
- Bleeding
- Anesthesia-related problems
- The need to switch to traditional surgical methods (eg, traditional laparoscopic or open surgery)
- Smoking
- Pre-existing heart or lung condition
- Obesity
- Diabetes
- Excessive alcohol intake
- Previous abdominal or pelvic surgery
- Use of certain medicines
What to Expect
Prior to Procedure
- Physical exam
- Blood tests
- Urine tests
- Electrocardiogram (ECG, EKG) —a test that records the electrical currents passing through the heart muscle
- Intravenous pyelogram (IVP) —a type of x-ray that creates images of the kidney, ureters, and bladder by injecting dye into the bloodstream
- Kidneys, ureter, bladder (KUB) —an x-ray of the abdomen
- Abdominal or pelvic ultrasound —a test that uses sound waves to visualize the inside of the body
- CT scan —a type of x-ray that uses a computer to create images of structures inside the abdomen or pelvis
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Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners such as clopidogrel (Plavix) or warfarin (Coumadin)
- Take antibiotics if instructed.
- Take a laxative and/or use an enema to clean out your intestines if instructed.
- Follow a special diet if instructed.
- Shower the night before using antibacterial soap if instructed.
- Arrange for someone to drive you home from the hospital. Also, have someone to help you at home.
- Eat a light meal the night before. Do not eat or drink anything after midnight.
Anesthesia
- General anesthesia —blocks pain and keeps you asleep through the surgery
- Local anesthesia—just the area that is being operated on is numbed; given as an injection and may also be given with a sedative
Description of the Procedure
- Forceps
- Scissors
- Dissectors
- Scalpels
| Laparoscopic Tools |
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| Copyright © Nucleus Medical Media, Inc. |
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
Post-procedure Care
- Wash the incisions with mild soap and water.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Take antibiotics to help prevent infection if instructed.
- Avoid certain medicines.
- Resume normal activities (eg, daily walks) soon. This will promote healing. You will have to avoid other activities, like driving, sexual activity, and strenuous exercise.
- Gradually progress from a liquid to a solid diet.
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To avoid
constipation
:
- Eat a high-fiber diet .
- Drink plenty of water.
- Use stool softeners.
- Be sure to follow your doctor's instructions.
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
- Abdominal swelling or pain
- Severe nausea or vomiting
- Persistent diarrhea or constipation
- Blood in the stool
- Pain and/or swelling in your feet, calves, or legs
- Cough, shortness of breath, chest pain
- Difficulty urinating, such as pain, burning, urgency, frequency, or persistent bleeding
- Being unable to eat or drink liquids
- Headache, feeling faint or dizzy
- Excessive vaginal bleeding (soaking more than one pad per hour) after a gynecologic procedure
- Persistent or foul smelling vaginal discharge after a gynecologic procedure
- Other worrisome symptoms
RESOURCES
American College of Surgeons http://www.facs.org/
National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/
CANADIAN RESOURCES
Canadian Cardiovascular Society http://www.ccs.ca/
Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/
References
American College of Obstetrics and Gynecologists website. Available at: http://www.acog.org/ .
Computer-assisted surgery: an update. Food and Drug Administration website. Available at: http://www.fda.gov/fdac/features/2005/405%5Fcomputer.html . Accessed December 9, 2008.
Da Vinci surgery. Da Vinci Surgery website. Available at: http://www.davincisurgery.com.procedures/gynecologic/index.aspx . Accessed December 9, 2008.
General surgical applications. Intuitive Surgical website. Available at: http://www.intuitivesurgical.com/clinical/generalsurgery/index.aspx . Accessed July 17, 2006.
Gynecologic applications. Intuitive Surgical website. Available at: http://www.intuitivesurgical.com/clinical/gynecologicapplications/index.aspx . Accessed July 17, 2006.
Laparoscopic abdominal surgery: bile, duct, and gallbladder. New York University School of Medicine website. Available at: http://www.nyulaparoscopy.org/surgeries/gallbladder.html . Accessed July 18, 2006.
Laparoscopic anti-reflux (GERD) surgery. Society of American Gastrointestinal and Endoscopic Surgeons website. Available at: http://www.sages.org/sagespublication.php?doc=PI01 . Accessed July 18, 2006.
Reproductive endocrinology and infertility. Duke University Medical Center website. Available at: http://medschool.duke.edu/ . Accessed December 9, 2008.
Ruurda JP, van Vroonhoven ThJMV, Broeders IAMJ. Robot-assisted surgical systems: a new era in laparoscopic surgery. Ann R Coll Surg Engl . 2002;84:223-226.
UNC robotic assisted minimally invasive surgery. University of North Carolina School of Medicine website. Available at: http://www.med.unc.edu/obgyn/gynrobotics/patients.htm . Accessed July 17, 2006.
6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.