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A Host of Treatments

 

The University of Illinois Medical Center at Chicago is home to the most advanced robot-assisted surgery program in the nation. It is also one of the most diverse programs of its kind, with practitioners having acquired the expertise to perform a large array of procedures.

 

Among them:

 

AdrenalectomyThis procedure involves removal of one or both adrenal glands, and typically is required to treat select endocrinological disorders, as well as benign or malignant tumors (primary or metastatic). Adrenalectomies traditionally are performed by conventional open surgery, and therefore require a large abdominal incison. With robotic-assisted surgery, the procedure is accomplished through four very small incisions.

 

Colectomy -- A colectomy, which calls for  full or partial removal of the colon, requires resection with corresponding blood vessels. The most common indications for colectomy include:

  • Colon cancer
  • Diverticulitis and diverticular disease of the large intestine.
  • Trauma
  • Inflammatory bowel disease such as ulcerative colitis or Crohn's disease.
  • Bowel infarction

Colectomies frequently are performed by laparotomy, which require a 20 cm incision. Robot-assisted colectomies require only small incisions, reducing surgical trauma and enhancing the postoperative recovery.

 

 

Esophagectomy -- Esophagectomies involve removal of all or part of the esophagus, and typically are performed to treat esophageal cancer. More rarely, indications are represented by esophageal atresia in children or caustic injury in adults.

The esophagectomy typically assumes two forms:

  • The transhiatal esophagectomy is performed on the neck and abdomen simultaneously.
  • The transthoracic esophagectomy involves opening the thorax, and replacing the esophagus with a portion of the stomach or colon.

Depending on the approach, an esophagectomy requires an abdominal incision (combined with a neck incision in the transhiatal procedure) or a combined abdominal and thoracic incision, also known as a transthoracic incision. The latter requires a 15-cm incision on the thorax and a large spreading of the ribs, with resulting rib fractures.

Both procedures are performed robotically at the University of Illinois Medical Center at Chicago. The transthoracic approach requires only four 8-mm incisions and eliminates need to spread the ribs.

 

Gastrectomy -- A gastrectomy calls for partial or full removal of the stomach to treat cancer or perforations. With open surgery, the procedure typically requires a 20 cm incision. A robot-assisted gastrectomy requires only five to six 8-mm.

 

Watch avideo of an actual procedure here.


 

Hepatectomy – This procedure refers to partial removal of the liver, and typically is performed to treat primary or secondary (metastatic) liver tumors. Hepatectomies frequently call for a large bi-subcostal incision with a median prolongation to control the liver’s vascular supply. With robot-assisted surgery, full or partial removal of the liver is achieved with four to five 8-mm incision. As a result, blood loss and postoperative analgesic consumption are visibly reduced. 

Watch a video of an actual procedure here.

Watch a patient testimonial here.

 

Lung resections -- Lung resections refer to excision of a lobe – a lobectomy -- or the entire lung -- a pneumonecotmy. Both procedures are performed to treat lung cancer and benign diseases, and normally require a 15-cm incision to the thorax and spreading of the ribs. Spreading the ribs results in chronic pain for long periods of time after surgey. By comparison, robot-assisted lung resections require only a limited incision, thereby eliminating the need for rib spreading. Results include reduced postoperative pain, early discharge and, when needed, early administration of chemotherapy.

 

Watch a video of an actual procedure here.

Listen to Dr. Giulianotti's comments on this procedure here.

 

Pancreatectomy – Pancreatic surgery, or removal of the pancreas, is one of the most challenging and complex procedures general surgeons encounter, as it traditionally requires wide exposure through a large incision; gentle dissection and tissue manipulation; correct interpretation of anatomy and blood supply; and very precise and accurate reconstruction of the biliopancreato-digestive anatomy.

Resection of the right part of the pancreas (its head), also known as Whipple operation, typically requires a long bi-subcostal incision, and results in significant postoperative pain and recovery time. The robot-assisted Whipple limits the length of the incision and reduces intra-operative blood loss, resulting in shorter recovery time. 

Watch the video of a Whipple procedure here.

Watch a video of a spleen preserving distal pancreatectomy here.

Watch a patient testimonial here.

 

Small Bowel Resection -- This procedure, which includes resection of part of the small bowel, is usually performed to treat inflammatory disease (such as Crohn's disease) or cancer. The resection can be performed robotically, with minimal postoperative pain and a short hospital stay.

 

Splenectomy -- Splenectomy refers to full or partial removal of the spleen to treat:

  • Lymphomas
  • Haematological disorders (idiopathic thrombocytopenic purpura)
  • Congenital erythropoietic porphyria (CEP) in the even that severe hemolytic anemia develops
  • Primary or secondary tumors

While a conventional splenectomy requires a 20 cm incision, a robot-assisted procedure requires only five 8-mm incisions and a 3-cm incision for specimen extraction. Results include less postoperative pain and a shorter hospital stay.

 

Thyroidectomy --  This procedure involves surgical removal of all or part of the thyroid gland. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or other conditions of the thyroid gland, such as hyperthyroidism. Conventional thyroidectomies are safe and effective, but require transverse incisions that can result in prominent scars, adhesions, hypesthesia and paresthesia at the neck.

To avoid scarring, the robot-assisted thyroidectomy accesses the thyroid through a 5-cm incision in the armpit. In addition to aesthetics, advantages include enhanced magnification of the cervical anatomy, lower incidence of postoperative hypesthesia or paresthesia, and less discomfort while swallowing.

Watch a patient testimonial here.

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