BioSketch In October 2004, Dr Kella completed his year long fellowship in urological oncology and robotic surgery under the guidance of Kevin Slawin at Baylor Medical School in Houston, Texas. He was raised in Dallas, Texas, but received his Bachelor degree in Chemical Engineering from Stanford University before returning to Texas to begin his medical school training at the University of Texas, Southwestern Medical School in Dallas. His surgical internship and urological residency were completed at Tufts School of Medicine in Boston, Massachusetts. He intends to set up his practice in the Midland/ Odessa area, where his wife, Reema, spent most of her formative years. Nick Shroff Nick Shroff spent 5 years (from 1972 to 1977) on the staff of Cook County Hospital, Chicago, Illinois where he did his surgical training, Urology Residency and urology (oncology) Fellowship. He is Board Certified in both adult and pediatric urology and has been a Diplomat of the American Board of Urology since February 1979. He has been running a private urology practice in Midland since August 1980. At Midland Memorial Hospital, he was on the Board of Trustees 1996-2000, Chief of Staff 1994, Chief of Surgery 1991. He was also Chief of Surgery 1982/83 at both the Physician and Surgeon Hospital and Parkview Hospital.
Our Surgeons and Robotic Surgery This is a description of radical prostatectomy using robotic surgery. Surgeons, Naveen Kella and Nick Shroff, using the da Vinci™ surgical robot, successfully performed two cases at the Alliance Hospital in Odessa, Texas. At this time, this is the only surgical robot available in the West Texas area. Both patients were able to go home on the second postoperative day and had complete removal of their cancer.
What is robotic surgery?
The arrival of robotic technology has dramatically enhanced a surgeon's abilities to perform minimally invasive surgery with precision and speed. With the da Vinci robot system, the surgeon is seated comfortably a few feet away from the patient at a control console, while the assistant stands by the operative table. Surgery is performed through 4 "key holes" (tiny) incisions, like standard laparoscopic surgery. However, the robotic instruments, about the diameter of a pencil, have wrist-like maneuverability, allowing the surgeon to move them like his own hand, as opposed to standard laparoscopic instruments, which have a much more limited range of motion. The advanced optics allow the surgeon to view the operative field at high magnification, while maintaining a three-dimensional perspective, unlike standard laparoscopic surgery. Finally, the dexterity of the surgeon's hand is enhanced by the robotic system, scaling motion to allow microsurgical movements, unequaled with either open or standard laparoscopic surgical approaches. Overview The Surgeon Console: Using the da Vinci™ Surgical System, the surgeon operates while seated comfortably at a console viewing a 3-D image of the surgical field. The surgeon's fingers grasp the master controls below the display with hands and wrists naturally positioned relative to his or her eyes. The technology seamlessly translates the surgeon's hand, wrist and finger movements into precise, real-time movements of our surgical instruments inside the patient. Patient-side Cart: The cart provides the three or four robotic arms - two or three instrument arms and one endoscope arm that execute the surgeon's commands. The laparoscopic arms pivot at the 1-cm operating ports eliminating the use of the patient's body wall for leverage and minimizing tissue damage. Other surgical team members assist in installing the proper instruments, preparing the 1-cm port in the patient, as well as supervising the laparoscopic arms and tools being utilized. EndoWrist® Instruments: A full range of instruments is provided to support the surgeon while operating. These instruments are designed with seven degrees of motion that mimic the dexterity of the human hand and wrist. Each instrument has a specific surgical mission such as clamping, suturing or tissue manipulation. The instruments are small and typically, fit within the circumference of a dime. Quick-release levers speed instrument changes during surgical procedures. InSite® Vision System with high resolution 3-D Endoscope and Image Processing Equipment: This component provides the true to life 3-D images of the operative field. Operating images are enhanced, refined and optimized using image synchronizers, high-intensity illuminators and camera control units.
What are the potential advantages of robotic prostatectomy?
What are the potential drawbacks of robotic prostatectomy?
Am I a candidate for robotic prostatectomy?
Outcomes after robotic prostatectomy
He has adopted new robotic surgery techniques that allow performance of the surgery without actually entering the abdominal cavity. We believe this makes the surgery safer for the patient and speeds the patient's recovery after surgery. This allows him to return to normal activity and work more rapidly and, down the road, avoids potential complications related to intra-abdominal surgery for the patient. Furthermore, Dr. Kella has now demonstrated in a new study, soon to be published, that he has maintained with robotic laparoscopic-assisted radical prostatectomy, our low positive margin rates traditionally seen with our mini-incision open radical prostatectomy technique.
Daniel Khouri, M.D.
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