I
n performing the world's first single-port robotic surgery, Jihad
Kaouk, MD, removed a patient's prostate and kidney through a
single umbilical incision. The patient left the hospital that same
day, missing not only a couple organs, but also the pain and
abdominal incisions that accompany a radical prostatectomy.
"The [robotic arm] turned a surgery that typically requires an
overnight stay into an outpatient procedure," says Dr. Kaouk, a profes-
sor of surgery and director of the Center for Robotic and Image
Guided Surgery in the Glickman Urologic and Kidney Institute at the
Cleveland Clinic in Ohio, one of the first U.S. prostate programs to
perform robotic radical prostatectomy. "Robotic single-incision sur-
gery results in less post-op pain, which we can manage without opi-
oids."
Operating through a single incision isn't the only clinical benefit of
operating with robotic assistance, says Dr. Kaouk. He's able to maneu-
ver the robot's arms outside of the extraperitoneal cavity, which lets
him avoid the bowel and prevent an ileus, a common side effect of
radical prostatectomies.
For now, the FDA has approved the single-incision robot used in
Cleveland Clinic's radical prostatectomies for only urologic surgeries,
but there are plans to expand its application to ENT and colorectal
procedures in the near future.
Single-incision robotic surgery shouldn't be seen as a tool to repli-
cate what surgeons have done with multi-arm robotic surgery, says
Dr. Kaouk. But, he points out, the technology provides a blueprint for
exploring procedures that aren't effectively accomplished with multi-
port robots and will lead to more surgeries being done on an outpa-
tient basis.
Dr. Kaouk is excited about the potential of single-incision robotic
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