Monday, March 19, 2012

Amazing breakthrough in minimally invasive robotic surgery

You have probably read about natural orifice cholecystectomy and appendectomy or removal of the gallbladder or appendix without an abdominal wall incision. These procedures have been limited to women because the natural orifice through which the surgery is performed and the diseased organ is removed has heretofore been the vagina.

The author of the first large study of transvaginal appendectomy, Dr. Kurt E. Roberts of Yale Medical School said men would need to have surgery through the stomach or rectum and quipped, “Finally, an advantage for women"

But now via Presse-Agentur Österreich (Austrian Press Agency) comes a report from the Schweinsteiger Institut für Experten-Chirurgie (Institute for Expert-Surgery) in Vienna of minimally invasive gallbladder surgery in three men. The natural orifice employed was the urinary bladder via the penis.

The men had elective surgery for chronic symptoms of right upper abdominal pain and gallstones. They are said to have tolerated the operations well and were discharged home within three hours of completion of their cases.

At a hastily called press conference, lead author of the research team and his eponymous institute, Professor Herr Doctor Bastien Schweinsteiger, explained how the revolutionary procedure was accomplished:“Using miniature instruments machined especially for the institute’s proprietary robot, called Michelangelo, the penis is cannulated and the bladder entered. A small enterotomy is made in the dome of the bladder and the gallbladder is grasped. A metallic grid is deployed and attached to the gallbladder. A powerful electromagnet is placed on the skin of the upper abdomen. When activated, the magnet lifts the gallbladder into a suitable position for dissection. After the cystic duct and artery are divided, the gallbladder is dissected free of the liver.

According to Dr. Schweinsteiger:“The most challenging part of the procedure was devising a method of extracting the gallbladder and stones through the penis. We finally realzed that we could place the gallbladder into a bag inside the abdomen and emusify the contents of the bag using the same type of sound waves used for lithotripsy of kidney stones thus allowing the gallbladder and bag to be drawn out through the penile urethra.“

Study co-author Dr. Miroslav Klose told the throng of curious reporters that an unexpected but welcome consequence of the surgery was improvement in urination in all three men presumably due to the dilatory effect of the gallbladder and bag traversing the prostate gland.

The researchers expect to launch a full-scale Phase II trial of this latest advance in minimally invasive robotic surgery sometime in late summer of this year.

Drs. Schweinsteiger and Klose disclosed that they are officers and stockholders in Scherz Roboter, the company that manufactures the Michelangelo robot.

Link to Presse-Agentur Österreich article here.

16 comments:

Anonymous said...

I don't even have a penis and this procedure makes me squirm.

Why is it a good idea? Is it really less traumatic than a laparoscopic choly?

Anonymous said...

Having been catheterized after receiving an epidural for an appendectomy, I feel uniquely qualified to say, "Do not want." I was playing ice hockey less than a week after my procedure, but the trauma of having that tube jammed into my penis still haunts me to this day, 16 years later.

Mark Pleatman MD said...

Triumph of technology over reason. It's all marketing hype. No advantage to the patient.

Anonymous said...

What a stupid thing to do. Hasn't he got anything better to use his skills on?

Anonymous said...

The link to the Austrian Newspaper is not working.

I also found this following link discrediting the whole story

http://urologieisoveral.blogspot.co.uk/2012/03/removing-gallbladder-through-penis.html

Anonymous said...

Fake post

Anonymous said...

Total farce. Great Joke. Both authors are soccer players on the German National Team.

Skeptical Scalpel said...

Thanks for all the comments and for making this my third most viewed post of all time.

Rugger said...

The whole SILS idiocy was solidified for me when a junior female resident of mine was telling me how cool SILS is and how that is what she wants to do when she grows up.
I said really, you think going through the stomach or bladder or whatever else is less risky?
She thought it was ok.
Now, mind you I am a big, 6'2'' guys, and I quipped back, "So, if you get cholecystitis, do you really want ME to go through your vagina to take out your gallbladder?"...she had to only think a few seconds before emphatically stating, "no way".
I LMAO.

Skeptical Scalpel said...

Rugger, Thanks for commenting. Here's a quote from a the Results section of a paper from Yale about trans-vaginal appendectomy (TVA), "42 patients were offered a pure TVA, 18 patients (42.8%) consented."

Here's a link to the abstract http://is.gd/KY6QZ4

Anonymous said...

Next step would be to perform the procedure in a space-shuttle, orbiting the planet. It would be a great step forwards for the Robotic companies and a giant leap backwards for the patients, the taxpayers and the insurance companies ! The freak-show must go on, folks !

Skeptical Scalpel said...

Thanks for the good laugh. I would not be surprised if someone hasn't thought to try that, but now the space shuttle no longer flies.

Anonymous said...

Here is another "breakthrough" for this "amazing" technology...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896382/

Article titled: "Vaginal Cuff Dehiscence After Robotic Total Laparoscopic Hysterectomy"

Two patients are presented, and the conclusion is:

"Robotic total laparoscopic hysterectomy may be associated with increased risk of vaginal cuff dehiscence and small bowel evisceration. This observation may be because of thermal spread and cuff tissue damage from electrosurgery used for colpotomy."

Personally, I think this is just the tip of an iceberg, and that there ought to be many more unreported cases.

How many patients have to suffer before the health authorities in respective country start to take a serious look into these and similar matters ?

Anonymous said...

REPORT TO THE FDA

I would suggest that any person in the USA being traumatized by Robotic Surgery,should consider reporting the incident directly to the FDA

https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm

Alternatively:

■ By phone- 1-800-FDA-1088

■ By FAX – obtain a fillable form online and print it out and fax it to 1-800-FDA-0178

■ By mail – or mail it to MedWatch, 5600 Fishers Lane, Rockville, MD 20852-9787


It is important that the tip of the Iceberg gradually is revealed down to the base, and that the authorities are notified in a proper manner.

Anonymous said...

NIGHTMARE FOR THE ROBOTNIKS:

Science and scientific assessment from a non-biased, non-profit organization constitutes a major setback for the Robotniks in their futile attempts to feed their Robots.

This also constitutes a major problem for Hospitals worldwide who have invested in this unproven technology, and now are more or less held hostage in their desperate need to reach economical and fiscal break-even with their investments.

The patients or rather "patients" (that is the majority of screened patients having clinically insignificant and minimal prostate "cancer")one can just CONGRATULATE - once more reason, science and thoughtfullness has prevailed.

http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm

Quote:

“Prostate cancer is a serious health problem that affects thousands of men and their families. But before getting a PSA test, all men deserve to know what the science tells us about PSA screening: there is a very small potential benefit and significant potential harms. We encourage clinicians to consider this evidence and not screen their patients with a PSA test unless the individual being screened understands what is known about PSA screening and makes the personal decision that even a small possibility of benefit outweighs the known risk of harms.”

USPSTF Co-Chair Michael LeFevre, M.D., M.S.P.H.
May 22, 2012

Anonymous said...

I was always taught: First, be safe. Second, ask for help if you need it.

Where does poking a hole in another organ, to gain access to the appendix/gallbladder, etc. qualify as safe? In what world would this be considered safe and with less risk than an incision through the peritoneum?

SILS and NOTES both fail test #1. Cosmesis takes a backseat to safety. Always.

Post a Comment