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  • Avera McKennan is First in the State to Offer Single-Incision Robotic Gallbladder Procedures

Published on August 31, 2012

Avera McKennan is First in the State to Offer Single-Incision Robotic Gallbladder Procedures


SIOUX FALLS (Aug. 31, 2012) - The first single-site robotic gallbladder surgery in South Dakota has been performed at Avera McKennan Hospital & University Health Center by Dr. Brad Thaemert, surgeon with Surgical Institute of South Dakota.

The FDA recently approved single-site robotic technology for minimally-invasive cholecystectomy, or gallbladder removal. Dr. Thaemert is the only surgeon in South Dakota trained to perform the procedure, and one of only a few hundred surgeons in the United States. Gallbladder surgery is the only procedure approved so far for single-site robotic surgery, but the technology has applications for a range of procedures which are currently being tested.

Avera McKennan first acquired da Vinci robotic technology in 2007, and added a second robotics system, the da Vinci Si™, in 2011. Avera McKennan was first in the state to offer this latest generation of robotic technology, which is capable of the single-site procedures with the addition of a new equipment platform attached to the robotic system.

“Gallbladder surgery has come a long way in the past few decades, from the traditional open procedure, to multi-site laparoscopic surgery, to single-site laparoscopic surgery, to robotic single-site surgery,” Dr. Thaemert said.

“The benefit to the patient of a single-site robotic procedure is essentially no visible scar after the incision heals,” Dr. Thaemert explained. All surgical instruments are inserted through a single port in the navel. Dr. Thaemert has been performing single-incision laparoscopic surgery since 2008, but only a limited number of thin patients qualify for that procedure, because it’s challenging for surgeons to manipulate all the needed equipment through a single site.

“Robotics makes it much easier because the instruments are more flexible and there’s more room to maneuver, so there are virtually no limitations placed on patients who can undergo the single-site procedure,” Dr. Thaemert said. Like laparoscopic procedures, the robotic single-site gallbladder procedure is performed on an outpatient basis.

“Gallbladder surgery is one of the most common procedures in the United States,” Dr. Thaemert said. Most patients undergo traditional multi-site laparoscopy, with three to four small incisions through which instruments are inserted. The da Vinci Si with the single-site platform allows surgeons to create one 1-inch incision through the navel, and this typically results in no visible scarring. This approach is intended to minimize pain, speed recovery and reduce blood loss and other possible complications.

“Laparoscopy is still a great procedure, because it’s done on an outpatient basis, and patients experience a fast recovery. Robotics takes minimally-invasive technology one step further by allowing for only one incision with no visible scar for a greater number of patients.” Patients are not charged additionally for use of the robot, Dr. Thaemert added.

The da Vinci® systems integrate three-dimensional, high-definition video and robotic technology to virtually extend the surgeon’s eyes and hands. The robotic unit includes a camera arm and two interactive robotic arms that have high-performance, miniature instruments attached to them. Seated at a console a few feet away from the operating table, the surgeon controls every movement of the robotic system, viewing a magnified, high-resolution 3D image of the surgical site. To operate, the surgeon moves master controls which translate into precise micro-movements of the surgical instruments.

Among the most common procedures involving robotics are hysterectomy and prostatectomy. Robotics are also used for pyeloplasty, adrenalectomy, sacral colpopexy, and other gynecologic procedures.

Dr. Thaemert traveled to Tulsa, Okla., and Celebration, Fla., for special training in performing the procedure. He says his first patients are doing well, and he’s only heard very good feedback from surgeons who have been using the technique for a longer time. “Patients are very excited about it and very satisfied,” he said.