Strong urologic surgeons perform cutting-edge minimally invasive surgery

Urologists at the University of Rochester Medical Center (URMC) are advancing the frontiers of minimally invasive surgery as they begin to introduce single-port access (SPA) surgery to the Rochester region.

Since November 2008, URMC urologists have completed six SPA surgeries entirely through the navel, including what is believed to be the nation's first single incision laparoscopic surgery to remove both kidneys from a patient.

Traditional laparoscopic surgery involves making up to a half dozen incisions in the abdominal area, with the number of holes dependent on the particular procedure being performed. Laparoscopic instruments and a camera are then inserted through the holes to complete the surgery; surgeons are able to view their work on video screens in real-time via broadcast signals from the tiny camera.

With SPA surgery, surgeons make only one small incision in the naval area, through which they insert flexible instruments. The tips of these newer instruments can be articulated and rotated 360 degrees, giving surgeons the ability to reach all necessary areas in a procedure.

According to Assistant Professor of Urology Guan Wu, M.D., who is leading the effort to introduce SPA surgeries here in Rochester, the nation's first SPA surgery was performed in May 2007 to remove a gallbladder. Since that time, SPA surgery has steadily been gaining ground nationwide and extended to a variety of more complex procedures.

"SPA is the next evolution of laparoscopic surgery," said Wu. "It allows us to further minimize minimally invasive surgery, while bringing multiple benefits to patients such as decreased risk of wound complications, shorter hospital stays and recovery time, less pain or discomfort, and little to no scarring."

Shawn Routly, 28, of Hilton, was Rochester's first patient to undergo a SPA procedure - and the first in the nation to have two kidneys removed using this technique. Routly, who has chronic kidney disease, spoke firsthand of the benefits.

"Unfortunately, over the years I've had lots of surgeries, so I'm familiar with recovery time when it comes to multiple incisions," Routly said. "But I couldn't believe how little pain I felt, and how quickly I recovered - I was home and walking around within two days. And, I was grateful that the scarring was minimal."

Wu said SPA surgery is still in its infancy, adding, "With further refinements in instrumentation and operative techniques, and with incorporation of robotic technology, SPA surgery will soon become the new standard to treat more medical conditions."