da Vinci^® ... Changing the Experience of Surgery at
Urology Specialists of Nevada

If you or a loved one has been diagnosed with a condition that may require surgery, you owe it to yourself to learn about all of your medical options, including the most effective, least invasive surgical treatments available.

The da Vinci^® Surgical System provides surgeons with an alternative to both traditional open surgery and conventional laparoscopy, putting a surgeon's hands at the controls of a state-of-the-art robotic platform. The da Vinci System enables surgeons to perform even the most complex and delicate procedures through very small incisions with unmatched precision.

For the patient, benefits may include:

• Significantly less pain
• Less blood loss
• Less scarring
• Shorter recovery time
• A faster return to normal daily activities
• And in many cases, better clinical outcomes

da Vinci  Prostatectomy

Facing any kind of urologic surgery creates a great deal of anxiety for most men. Among your concerns is: Will my body function normally following surgery? Traditional open urologic surgery in which large incisions are made to access the pelvic organs has been the standard approach when surgery is warranted. Yet common drawbacks of this procedure include significant post-surgical pain, a lengthy recovery and an unpredictable, potentially long-term impact on continence and sexual function.

da Vinci Surgery, a minimally invasive approach that utilizes the latest in surgical and robotics technologies, is ideal for delicate urologic surgery. This includes prostatectomy, in which the target site is not only tightly confined but also surrounded by nerves affecting urinary control and sexual function.

Learn More: da Vinci Prostatectomy

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

¹ Johnson W, Demaria E. Surgical treatment of obesity. Curr Treat Options Gastroenterol. 2006 Apr;9(2):167-74.

da Vinci  Nephrectomy

da Vinci Surgery for kidney conditions uses the best techniques of open surgery and applies them to a robotic-assisted, minimally invasive approach. With da Vinci Surgery, doctors may perform what's called a nephrectomy or partial nephrectomy – removal of all or part of the kidney.

The precision and dexterity of the da Vinci Surgical System's advanced instrumentation provides for a minimally invasive approach to treating kidney disorders and kidney cancer.

Learn More: da Vinci Nephrectomy

As with any surgery, these benefits cannot be guaranteed, as surgery is patient and procedure specific.

If you are a candidate for kidney surgery, talk to a urologist who performs da Vinci kidney procedures.

In Nephrectomy, one incision is enlarged for removal of the kidney.

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

da Vinci  Pyeloplasty

If your doctor recommends surgery to treat urinary obstruction, you may be a candidate for a new, minimally invasive approach - da Vinci® Surgery for Urinary Obstruction. This surgery, known as pyeloplasty, removes the blockage in the urinary system. During surgery, your doctor will reattach the healthy part of the kidney to the healthy part of the ureter – the narrow tubes that carry urine from the kidneys to the bladder.

da Vinci Surgery uses state-of-the-art technology to help your doctor perform a more precise operation than conventional surgery. It offers several potential benefits over a conventional open surgery, including:

da Vinci Surgery incorporates the best techniques of open surgery and applies them to a robotic-assisted, minimally invasive approach.

The precision and dexterity of the da Vinci Surgical System allows for a minimally invasive approach in treating urinary obstructions. As with any surgery, these benefits cannot be guaranteed, as surgery is unique to each patient and procedure. If you are a candidate for a pyeloplasty, talk to a urologist who performs da Vinci surgery for urinary obstructions.

Learn More: da Vinci Pyeloplasty

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

da Vinci  Adrenalectomy

An adrenalectomy is the surgical removal of one or both adrenal glands. The procedure can be performed using an open incision or laparoscopic technique.

The adrenal glands are endocrine glands located above each kidney. Malignant or benign tumors in the adrenal gland are the most common conditions requiring adrenalectomy. Some adrenal gland tumors excrete hormones. If left untreated, these tumors can cause severe hormonal imbalances.

Procedure
To perform laparoscopic surgery, your surgeon will make three to four small incisions, and insert tube-like instruments through them. The abdomen will be filled with gas to help the surgeon view the abdominal cavity. A camera will be inserted through one of the tubes that will display images on a monitor in the operating room. Other instruments will be placed through the additional tubes. In this manner, your surgeon will be able to work inside your abdomen without making a larger incision.

There are several different approaches the surgeon may choose when performing an open adrenalectomy. These include a horizontal incision under the rib cage, a vertical incision in the middle of the abdomen, a posterior incision along your back just under the rib cage, or flank incisions on each side of the body. Your surgeon will decide which approach is right for you.

Once inside, the surgeon will disconnect each adrenal gland from the many blood vessels that feed it. The blood vessels will be tied off to stop bleeding. When the adrenal gland is disconnected, it will be removed. After the cavity is washed with a warm saline solution, the surgeon will close the wound and suture the muscles together. The skin will be sutured or stapled, and the incision covered with a dressing.

If the surgery is performed laparoscopically, a plastic bag will be inserted into the abdomen via one of the small incisions, and the adrenal glands will be placed inside the bag. The bag and its contents will then be removed through an incision in the belly button.

da Vinci  Nephroureterctomy

Procedure
Three to four small cylindrical tubes called trochars measuring 5 to 12 mm are placed into the abdominal or retroperitoneal cavity. A video-telescope, called a laparoscope, is placed through one of the trocars. The laparoscope provides the surgeon a magnified view of the operating field and allows identification of vessels and structures with more clarity than is possible in open surgery. Specially designed laparoscopic instruments are placed through the other trochars. This technique allows the surgeon to secure the renal vessels, remove the kidney and ureter from all their surrounding structures with more accuracy and better visualization then the traditional open techniques. Once freed, the kidney and ureter is placed in a specially designed laparoscopic bag and is extracted from a small 3 inch incision often hidden in the pants line.