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 robotic 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.

More details are available at a link to the Presse-Agentur Österreich article here.