Services: Robotically Assisted Surgery
More advanced than the original da Vinci® surgical system, the da
Vinci S increases the types of surgical procedures that can be performed by skilled
UF surgeons. The da Vinci S utilizes four robotic arms that insert surgical instruments
into tiny incisions less than the size of a dime.
The surgeon is in complete control of the da Vinici S and guides the surgical instruments
by watching the area on a high definition monitor. With instruments that provide
better dexterity and range of motion than the human hand, the surgeon gains greater
control and precision than found in traditional open operations and some laparoscopic
Patients benefit by having more options for minimally invasive procedures - many
not performed elsewhere in Northeast Florida and Southeast Georgia. University of
Florida surgeons at UF Health Jacksonville can perform the following operations
using the da Vinci S:
Your physician can refer you to a surgeon at UF Health Jacksonville to see if robotically
assisted surgery is right for you.
Part of the body's endocrine system, the adrenal glands are located on top of each
kidney. The adrenals secrete powerful hormones directly into the bloodstream that
regulate sodium and potassium levels, raise the level of sugar in the blood, control
some sexual functions and secrete the "flight or fight" hormone adrenaline.
Tumors or enlargement of these glands may secrete an abnormal amount of the hormones
and can affect the patient's metabolism. These are usually benign growths, but occasionally
may be cancerous. Tumors left untreated can secret abnormal levels of hormones causing
a severe imbalance. After removal of one of the adrenal glands (adrenalectomy),
the body produces a normal amount of adrenal hormones. When both glands are removed,
patients must take supplemental adrenal hormone replacement medication.
Because the esophagus does not have a mucus lining like the stomach, it can become
irritated by acid that abnormally flows back (refluxes) from the stomach. Anti-reflux
fundoplication is a procedure for treating gastroesophageal reflux disease (GERD).
GERD results when acid refluxes from the stomach back up into the esophagus. GERD
is normally prevented by a functional muscular valve at the junction of the esophagus
and stomach, the lower esophageal sphincter (LES). Most of the time, this sphincter
is contracted to close off the esophagus from the stomach, acting as a barrier.
In patients with GERD, the sphincter is either weak, relaxes inappropriately, or
is forced open by a hiatal hernia. GERD causes inflammation, heartburn and other
serious complications, such as scarring and narrowing of the esophagus. During an
anti-reflux fundoplication procedure, the part of the stomach closest to the esophagus
is sewn around the lower end of the esophagus. This procedure increases the pressure
at the lower end of the esophagus to strengthen the valve function and reduce acid
The gallbladder's main function is to store and concentrate bile, which is produced
by the liver, and to release it for digestion. While the gallbladder performs an
important function, it is not an essential organ.
It may be necessary to remove the gallbladder in patients with gallstones or those
in which the gallbladder is not functioning normally (biliary dyskinesia). Gallstones
(small, solid formations composed of cholesterol, pigment, and bile salts) are the
most common disorder and can cause problems in the gallbladder and the rest of the
biliary system, including the pancreas. Surgical removal, known as a cholecystectomy,
is the most common therapy for gallbladder disorders.
Cystoprostatectomy is surgical removal of the urinary bladder and prostate gland
to eliminate muscle-invasive bladder cancer. Because the prostate gland and bladder
are closely located within the body, removal of the prostate is usually done at
the same time as the bladder in males. Removal of the bladder and prostate together
reduces the risk of tumor spillage and reduces the risk of leaving bladder cancer
cells on the prostate gland if it were allowed to remain. Removal of the bladder
using the da Vinci robot typically allows for less blood loss and quicker recovery.
Esophageal (Heller) Myotomy for Achalasia
Achalasia is the second most common swallowing disorder after GERD and affects the
esophagus in which the lower esophageal sphincter (a ring of muscle between the
lower esophagus and the stomach) is unable to open and let food pass into the stomach.
As a result, patients with achalasia have difficulty swallowing food. Left untreated,
achalasia may cause the esophagus to become enlarged and eventually stop functioning.
Causes of achalasia are not well understood; however, it is seen primarily in young
women and middle-aged men and women. Patients with untreated achalasia are at a
greater risk of developing esophageal cancer.
A Heller myotomy is a procedure for the treatment of achalasia during which the
surgeon cuts the muscles of the lower esophageal sphincter to allow food to pass
more easily into the stomach. Robotic assistance allows a more precise and accurate
cutting of the affected sphincter muscle.
This procedure involves removal of all or part of the stomach. The body's digestive
system uses the stomach to receive and break down food into nutrients that can be
absorbed by the small intestine. If the stomach is completely removed, the esophagus
is connected directly to the small intestine, which requires some dietary changes.
Stomach-related operations performed with robotic assistance include removal of
cancerous or benign tumors, ulcer repair, insertion of gastric pacemakers and gastric
bypass to relieve obstructions of the stomach and upper intestine.
A surgical treatment for severe obesity, gastric bypass involves isolating a small
section of the stomach to form a pouch to hold food as it passes from the esophagus.
A part of the small intestine is disconnected from the upper intestinal tract and
connected directly into this pouch. Because the pouch is small - and initially holds
only one or two ounces of food - the patient is able to eat only small meals and
over time can lose significant amounts of weight. Robotically assisted gastric bypass
gives the surgeon greater precision and ability to operate on patients considered
too heavy for open or laparoscopic procedures.
Severely obese patients may be recommended to have gastric sleeve surgery. The surgeon
removes approximately 60 percent of the stomach, leaving a sleeve-shaped portion
to receive and digest food. Reduction in stomach size forces patients to lose weight.
A significant advantage to the gastric sleeve procedure is that it requires no re-routing
of the digestive system. Surgeons performing gastric sleeve using the da Vinci S
can complete the procedure in about 90 minutes, and with the greater dexterity provided
by robotics can ensure that sutures are tied tightly to close the stomach walls.
Severely obese patients may be recommended to have a duodenal switch operation.
This is performed in conjunction with a gastric sleeve, and like gastric bypass,
a significant portion of the upper small intestine is bypassed in order to decrease
the absorption of the food that is eaten.
A woman's uterus (or womb) is part of her reproductive system and is home to a developing
fetus during pregnancy. A healthy uterus rarely needs to be removed, but a number
of factors can precipitate removal as treatment. Conditions such as excessive fibroids,
endometriosis (where uterine tissue grows outside the uterus covering ovaries and
fallopian tubes), uterine prolapse (when the uterus falls into the vagina or persistent
vaginal bleeding, may call for a hysterectomy. The most common form of hysterectomy
is the complete or total hysterectomy that removes the uterus and cervix. A partial
hysterectomy removes the uterus and leaves the cervix in place. Radical hysterectomies
remove the uterus, cervix and the upper part of the vagina. Although not always
necessary, ovaries and fallopian tubes may be removed during a hysterectomy.
Most hysterectomies are performed abdominally with a "bikini" incision in the pelvic
region or vaginally, which removes the uterus through the vagina. Robotically assisted
hysterectomies increase the number of women eligible for minimally invasive options
by using tiny incisions to extract the uterus and other associated organs or tissues.
Abdominal hysterectomies can require up to four weeks recovery time and may involve
excessive surgical blood loss. With robotically assisted hysterectomies, most women
can return to normal activities within one to two weeks and have minimal scaring
for a better cosmetic outcome.
Myomectomy is the removal of fibroid tissue in the uterus. Fibroids are non-cancerous
tissue masses that occur in a large number of women of childbearing age. Most women
with fibroidal tissue never show symptoms. When symptoms such as severe, painful
cramping, heavy menstrual bleeding, bleeding between periods, unusual constipation
and urinary incontinence or frequency do not respond to other therapies, removal
may be the best option. Often done as open surgery, robotically assisted myomectomies
reduce recovery time and have proven advantageous when a women wishes to preserve
fertility and keep her uterus intact.
Nephrectomy and Living-Related-Donor Nephrectomy for Transplantation
The body has two kidneys located just below and behind the liver on the right and
below the spleen on the left. The kidneys play a major role in overall health and
are responsible for filtering fluid wastes from the bloodstream (urine) and storing
the liquid wastes in the bladder until expelled. A kidney damaged by injury, cancer
or excessive cysts may need to be removed. If the remaining kidney is healthy, over
time it compensates for the missing kidney and resumes its blood filtering function
with little to no difficulty.
A nephrectomy is also performed when a living donor, usually biologically related,
has one kidney removed for transplantation. Success rates for transplanting a kidney
from a living-related donor are much higher than when using kidneys from deceased,
unrelated donors. Recovery time for the living-related donor is usually swift and
When small tumors suspicious for cancer are present in the kidney, they can sometimes
be removed and the remainder of the kidney left behind. This is known as a partial
nephrectomy. This is desirable whenever possible because a health partial kidney
may have enough function to keep a person off dialysis if it were the only kidney
The pancreas is part of the body's endocrine system and lies across and behind the
stomach. It produces digestive enzymes and hormones and insulin to regulate blood
sugar. Removal of all or part of the pancreas may be necessary to treat cancer,
eliminate cysts or other benign tumors, or to treat pancreatitis.
With a distal pancreatectomy, only a part, typically the end, of
the pancreas is removed and the pancreas continues to function in a normal fashion.
A total pancreatectomy removes the entire pancreas and parts or
all of digestive organs associated with it. Patients having total pancreatectomies
have to take digestive enzyme supplements and insulin for the rest of their lives.
The prostate is a walnut-shaped gland found in the pelvic region of men, just under
the bladder and in front of the rectum. It surrounds the urethra, the tube that
drains urine from the bladder and out the penis, and when enlarged can create urination
difficulties. The prostate's prime function is to produce seminal fluids necessary
for sperm transportation. While studies are inconclusive as to the cause of prostate
cancer, the disease is the most common form of cancer in men.
A prostatectomy is the removal of all or part of the prostate and surrounding tissue
to eliminate cancer and abnormal cell growth. With early detection and removal,
survival rates are high. Post-prostatectomy treatment for possible bladder incontinence
and sexual dysfunction may be necessary. Robotic assistance during this procedure
gives the surgeon greater dexterity and ability to probe deeper with better visualization
than other surgical options.
A pulmonary lobectomy is an operation to remove a lobe of the lung. A lobectomy
is performed to treat lung conditions such as lung cancer, congenital defects, cysts,
tuberculosis and emphysema. While a traditional lobectomy involves making a large
incision and spreading the ribs to remove the lung lobe affected by the tumor, surgeons
using the da Vinci S are able to make several small incisions between the ribs to
remove the lobe. Patients who undergo robotically assisted lobectomy typically experience
less pain and fewer complications.
Small Intestine, Colon and Rectum Resection
A number of causes can contribute to perforation, bleeding, inflammation or obstruction
of the small intestine, colon and rectum, inhibiting the normal passage of feces,
including injury, cancer, diverticulitis, rectal prolapse, ulcerative colitis or
Crohn's disease (an inflammatory bowel disease). An intestinal resection is the
removal and repair of the diseased section of small or large intestine. When small
sections are required to be removed, the ends are connected to each other. Most
patients reach full recovery and return to normal intestinal function, although
rectal cancer patients sometimes require a colostomy and may undergo additional
treatment such as radiation and chemotherapy.
The function of the spleen is to remove bacteria as well as dead and dying blood
cells from the body, creates and stores new red blood cells, and assists in fighting
certain types of infections. The spleen may need to be removed due to injury or
a number of diseases, including acute and chronic leukemia, thrombocytopenia, cysts,
splenic tumors, splenic artery aneurysms, or a variety of anemias.