What is Laparoscopic and Robotic Surgery?
Laparoscopic surgery is a surgical approach whereby the abdomen is inflated with carbon dioxide to create a “working space.” This is in contrast to conventional open surgery where a larger incision is required thereby exposing the surgical field to the open air for surgeon access. Visualization of the abdomen and internal organs in laparoscopy is accomplished through a 1 cm incision through which a camera lens is inserted to obtain a video image. The operating instruments are then inserted through even smaller incisions to perform the necessary surgery.
History of Minimally Invasive Surgery and the Advantage of Robotics
Urology was one of the first surgical fields to utilize laparoscopic surgery and since the early 1990s, when the first laparoscopic radical nephrectomy was performed, urologists have continued to innovate and be at the forefront of minimally invasive surgical techniques and technologies. Robotic-assisted laparoscopic surgery, which became available in 2000, builds on the benefits of laparoscopy, while significantly enhancing the surgeon’s ability to see and perform careful dissection. This ability is a direct result of the specific design of the da Vinci surgical system (Intuitive Surgical) whose instruments have seven degrees of freedom of movement like the human hand and wrist (Figure – hand and instrument articulation). This breakthrough is one of several factors that give robotic-assisted laparoscopic surgery an advantage over standard laparoscopy. In addition the da Vinci surgical system is armed with a highly sophisticated camera that produces a three-dimensionalhigh-definition live video image of the operative field for the surgeon (Figure – console view Si and Figure – surgeon console Si). The effect is akin to putting a miniature version of the surgeon inside the patient.
Due to the high sophistication of robotic surgery it is imperative that not only the surgeon be skilled, but that the entire operating room team has advanced training and are dedicated to the procedures being performed. This includes anesthesiology, nursing, and operating room support staff. Dr. Berkman has invested significant time training and refining his robotic surgery team. This team approach to advanced robotic surgery ensures that you receive the safest most efficient care possible. It is one more factor that sets Dr. Berkman apart.
The following is a list of conditions that Dr. Berkman treats through a minimally invasive robotic approach. Select a condition below to learn more.
- – Adrenal tumors (Adrenocortical carcinoma, Pheochromocytoma, functional and nonfunctional adrenal adenomas)
- – Benign kidney tumors (angiomyolipoma, renal cyst)
- – Bladder cancer
- – Bladder diverticula
- – Conn’s syndrome
- – Cushing’s syndrome
- – Kidney cancer
- – Penile cancer
- – Prostate cancer
- – Retroperitoneal fibrosis
- – Testicular cancer
- – Transitional cell carcinoma of the renal pelvis and ureter
- – Urachal tumors and cysts (lesions of the urachus)
- – Ureteral stricture
- – Ureteropelvic junction obstruction (UPJ)
The following is a list of the most common robotic surgical procedures that Dr. Berkman performs in the treatment of his patients. With these advanced surgical approachesDr. Berkman brings to his patients and the community state-of-the-art techniques and technologies. His fellowship training in minimally invasive urologic oncology insures that his patients receive the most current and effective treatment for their condition while minimizing the overall trauma of surgery. Please click on any of the links below for further information.
- – Robotic Prostatectomy
- – Robotic Radical Nephrectomy
- – Robotic Partial Nephrectomy
- – Robotic Cystectomy
- – Robotic Nephroureterectomy
- – Robotic Adrenalectomy
- – Robotic Upper Urinary Tract Reconstruction: Robotic Pyeloplasty and Related Procedures
- – Other Robotic Procedures (diverticulectomy, excision of urachal remnant, distal ureterectomy, ureteral reimplant and psoas hitch, ureterolysis)
- – Robotic Simple Prostatectomy