Division of Advanced Laparoscopy and Robotics
Our Division of Advanced Laparoscopy and Robotics provides some of the most advanced and least invasive urological procedures available. Chesapeake Urology's highly trained surgeons are leaders in using laparoscopic techniques. In these procedures, surgeons make several tiny incisions instead of one large one, inserting a tiny instrument with a miniature video camera to view the affected area while surgical instruments are inserted into the other small incisions. Patients that receive minimally invasive treatments experience less pain while recovering more quickly and suffering fewer complications.
Many of our surgeons also use state-of-the-art robotics to improve the precision and successful outcomes of certain laparoscopic procedures. In fact, CUA urologists performed the first robotic cystectomy (bladder removal) in Maryland and the first robotic prostatectomy (prostate removal) in a Maryland community hospital. The robot provides superb visibility, acts like an extension of the surgeon's hands and also provides a third "hand" to help give better access to the area undergoing surgery. Robotic procedures are available at several of our locations.
We perform the following minimally invasive procedures:
Laparoscopic Nephrectomy
Less invasive kidney removal
Your kidney may need to be removed due to cancer, or other factors such as chronic infection, polycystic kidney disease, hypertension or renal calculus. The most common kidney cancer is renal cell cancer, followed by transitional cell cancer (cancer of the renal pelvis, the part of the kidney that collects and stores urine).
How it works - when a disease requires that all or part of your kidney be removed, our specially-trained urologists can remove the kidney laparoscopically under general anesthesia, using three to four tiny incisions for the instruments and a three-inch incision to remove the kidney. This replaces open or traditional surgery where the incision is typically 10 inches long. In a simple nephrectomy, just the kidney is removed. In a radical nephrectomy, the adrenal gland and possibly the lymph nodes around the kidney also may be removed to reduce the likelihood that your cancer will spread.
Benefits - In addition to faster recovery and less pain, this minimally invasive procedure also reduces blood loss, enhances precision and improves outcomes.
Robotic Prostatectomy
Removing the prostate with small incisions and robotic assistance
Prostate cancer is the second most common cancer affecting U.S. men, after skin cancer. Chesapeake Urology surgeons performed the first robotic-assisted prostatectomy in a Maryland community hospital in 2005. In this innovative procedure, surgeons remove the prostate and seminal vesicles.
How it works - to remove the prostate, and sometimes surrounding lymph nodes, the surgeon makes five small incisions, each about 1/3 inch wide, in your abdomen. While you are under general anesthesia, the surgeon moves two of the robotic arms while the third "arm" keeps other structures out of the way. Very small movements of the surgeon's fingers control tiny instruments for precise movements. The camera's magnified, 3-D vision allows the surgeon to better identify and preserve the nerves that control erection and the sphincter muscle that maintains bladder control. The prostate is removed through an incision approximately one inch long.
Benefits - robotic prostate removal is more precise, with reduced blood loss, fewer complications and a shorter recovery than open surgery. Whenever possible, physicians spare the nerves next to the prostate to preserve bladder control and the ability to have an erection.
Robotic Cystectomy
Precise bladder removal
Bladder cancer is the fourth most common male cancer and the eighth most common female cancer. When non-surgical options are not appropriate or have failed to work, your surgeon may recommend bladder removal to treat your cancer.
How it works - In a procedure called robotic cystectomy, your bladder can be removed less invasively with several small incisions. After the bladder is removed, the surgeon can sometimes create a new bladder using part of your intestines to avoid needing an appliance to urinate. The procedure is performed using general anesthesia.
Benefits - less blood loss, fewer complications, faster recovery and for some patients, the ability to urinate normally without an appliance.
Laparoscopic Pyeloplasty
Four small incisions recreate a normal connection between kidney and ureter
A robotic pyeloplasty is a procedure that may be performed on either children or adults to fix an abnormal connection between your kidney and your ureter, the tube that connects the kidney to the bladder. Some people are born with this condition, or it may be caused by scar tissue. This condition usually causes flank pain and nausea ad can eventually lead to kidney failure.
How it works - the abnormal connection is removed and a healthy section of your ureter is attached to a healthy part of your kidney. Surgeons use four tiny incisions in the abdomen instead of a large one. With state-of-the-art robotics, the surgeon has a 3-D magnified view. Using the delicate movements of the robotic arms, the surgeon is able to reconnect the ureter to the kidney more precisely.
Benefits - more precise, faster recovery, less pain, safer, no disfiguring incision.
Retroperitoneal Lymph Node Dissection (RPLND)
Removing lymph nodes to keep cancer from spreading
This minimally invasive procedure removes the lymph nodes in the lower back and pelvic area that may become cancerous when you have testis cancer or renal cell cancer.
How it works - doctors make several tiny incisions below the navel and insert the laparoscope and other tiny surgical instruments into the lower abdomen to remove the lymph nodes.
Benefits - in contrast to traditional large-incision surgery, laparoscopic surgery often allows doctors to prevent nerve damage that can cause retrograde ejaculation, a condition where semen flows into the bladder rather than the penis, causing sterilization. The procedure is also more precise, with faster recovery and less pain than conventional surgery.
Nephroureterectomy with bladder cuff
Removing the kidney and ureter through small incisions
This procedure is used when you have transitional cell cancer, cancer that affects the cells in the renal pelvis (the part of the kidney that collects and stores urine) and the ureter (the tube that carries urine from the kidney to the bladder). Doctors remove the entire kidney, the ureter and the bladder cuff (the part that connects the ureter to the bladder) to remove the cancer and keep it from spreading.
How it works - the doctor makes several tiny incisions above the navel and then inserts surgical instruments and the laparoscope to detach the kidney and ureter. The surgeon then makes a 6 or 7 inch incision just above the pubic (hip) bone to remove the kidney, ureter and bladder cuff.
Benefits - minimizes pain, shortens the hospital stay, speeds recovery and is more cosmetic.
Cryosurgery for kidney cancer
Freezing cancerous kidney cells
When a kidney tumor is small or when partial or complete kidney removal is not an option, your doctor may recommend cryosurgery to freeze and kill the tumor using small incisions.
How it works - your physician will insert a small hollow probe called a cryoprobe into the upper abdomen and into the cancerous area of your kidney. Liquid nitrogen is injected into the tumor to freeze its cells and kill them.
Benefits - the treatment permits a shorter hospital stay, faster recovery with less discomfort. It can also safely be repeated if needed, and it can be performed along with other treatments.
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