Tiny Incisions for the Littlest Patients

11/10/2009

Since the da Vinci robotic surgical system made its debut at Lafayette General in 2007, its use for adult prostatectomies and hysterectomies has become well known, and even mainstream.  Less well known is the robot’s use for pediatric urologic procedures that provide the same great benefits of minimally invasive surgery to children. Dr. Thomas Forest, sub-specialty certified in pediatric urology, has treated several different urologic disorders in children over the last two years with da Vinci.

“The da Vinci, having tiny laparoscopic instruments that can bend and twist with the same motion as my hands, is well-suited for pediatric surgery,” says Dr. Forest.  “With the small internal structures of a child, the robot’s 3-D magnification allows me to better visualize inside the body, and to be more precise.  Instead of a long open incision, three to four, centimeters-wide cuts means less blood loss, less pain, and a shorter hospital stay.”

To date, Dr. Forest has performed robotic surgery on children from 7 months to 18 years.  One such surgery, known as pyeloplasty, corrects a condition called ureteropelvic junction (UPJ) obstruction.  The UPJ is where the kidney and the ureter, the tube that carries urine from the kidney to the bladder, join.  Fourteen-year-old Trevor Alleman had the UPJ blockage removed, and his ureter reattached to his kidney, by Dr. Forest and theda Vinci system two years ago.

“Using the da Vinci was much easier than if open (incision),” says Kayla Alleman, Trevor’s mother.  “With open surgery, he would have been miserable—in the hospital longer, had more risk of infection, more pain.  Now, he only has a couple of small scars on his abdomen.”

When asked if she was nervous about using the robot, Alleman replies, “I didn’t even know there was one here!  No, I was excited, and glad they had something like that in Lafayette.  The procedure sounded so much better than a wide-open incision, and Trevor was really comfortable with it.  He loves sports, and with (da Vinci) he could play again sooner.”

Dr. Forest adds, “In this case, Trevor was able to go home in just a few days, whereas in an open procedure the child would have to spend three to seven days in the hospital.  His tiny incisions have healed beautifully, and so far he’s had no complications, no further need for treatment.”

Other conditions the urologist / robot team have corrected:

  • nephroureterectomy. In this procedure, both the damaged kidney and ureter (tube that carries urine from kidney to bladder) are removed.
  • duplex kidney repair.  This condition occurs when two ureters, or tubes, drain one of the kidneys.
  • congenital obstructed megaureter.  An abnormality from birth (congenital), the kidney and urinary tube are severely dilated and blocked at the bladder junction

Though da Vinci is referred to as robotic surgery, it is important to note that the surgeon controls the movement of the robot at all times while sitting at the specially designed console a few feet away from the patient.

In addition to pediatric urologic procedures, the system is being used at Lafayette General for prostatectomy (removal of the prostate gland) and hysterectomy (removal of the uterus).  Other LGMC urologists trained on da Vinci include Drs. Samuel Shuffler, Brad Roth, and Chris Fontenot. Drs. Allison Taylor, Daniel Bourque, and Francis Cardinale, obstetrician/gynecologists, utilize the da Vinci to perform hysterectomies.

For more information about the da Vinci Surgical System at Lafayette General, please visit our surgery section.

As the largest, full-service, acute-care medical center in the nine parishes of Acadiana, Lafayette General Medical Center takes to heart its mission of improving, maintaining and restoring the health of people in the communities we serve.  LGMC is a community-owned hospital, and as such all profits are reinvested in the hospital for purchasing unsurpassed technology, maintaining a highly trained staff and adding new and improved services.

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