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Winthrop Physicians Offer Surgery without the Scars

Gone are the days when undergoing surgery meant visible scars, a long hospital stay and a painful recovery. At Winthrop-University Hospital, surgeons are using the latest laparoscopic surgical innovation – minimally invasive Single Incision Laparoscopic Surgery (SILS™) – to treat a range of conditions through a single incision in the belly button.

During a SILS procedure, the surgeon makes a small incision in the patient’s belly button and inserts a SILS™ Port – a soft, flexible laparo - scopic port with three openings. Specialized instruments, which provide maximum versatility and range-ofmotion, are then passed through the openings in the port and the surgeon is ready to work.

The SILS procedure can offer patients several advantages over traditional laparoscopic surgery, including one access point in the abdomen which minimizes scarring and the post-surgical pain that is often associated with additional sites of entry, leading to a faster recovery.

At Winthrop, there are currently several SILS procedures available. Generally, patients who are candidates for laparoscopic surgery are also candidates for SILS, but each patient is evaluated on an individual basis.

SILS Hysterectomy

Hysterectomy – the removal of the uterus – is the most frequent surgical procedure among reproductive-aged women after cesarean section.

“A hysterectomy may be performed to treat a variety of gynecologic conditions affecting a woman’s reproductive system, ranging from fibroids and chronic pelvic pain to uterine, ovarian and cervical cancers,” said Edward A. Jiménez, DO, attending physician in the Division of Gynecologic Oncology at Winthrop. Dr. Jiménez performs SILS as well as robotic-assisted laparoscopic hysterectomies and myomectomies for the removal of uterine fibroids.

The list of surgeons performing SILS™ procedures at Winthrop is continually growing. Winthrop surgeons who are currently using SILS include:

Alexander Barkan, MD
Procedures: Cholecystectomy, Sleeve Gastrectomy

Collin Brathwaite, MD, Chief of the Division of Minimally Invasive and Bariatric Surgery
Procedures: Cholecystectomy, Sleeve Gastrectomy

David Halpern, MD
Procedure: Cholecystectomy

Edward A. Jiménez, DO
Procedures: Hysterectomy, Oopherectomy

Michael Khalife, MD
Procedure: Cholecystectomy

William P. Reed, MD, Chairman of the Department of Surgery
Procedures: Cholecystectomy, Appendectomy
“SILS hysterectomy is a good option for patients who are candidates for laparoscopic surgery and want a better cosmetic result due to the single incision in the belly button,” said Dr. Jiménez.

Dr. Jiménez also uses SILS to perform partial and total Bilateral Salpingo-Oophorectomies (BSOs) – the surgical removal of both the ovaries and fallopian tubes. Candidates for these procedures can include patients with ovar ian masses and women with genetic risk factors for ovarian cancer who wish to have their ovaries removed as a preventative measure.

This procedure also offers some very tangible benefits to women like Barbara Tavora-Jainchill of Woodbury who juggle a demanding career and busy home life. Thanks to single incision laparoscopic surgery, they can do what they want to do most – get back to their lives as quickly as possible.

“Having traditional surgery and being out of commission for six to eight weeks would have wreaked havoc in my house,” said Mrs. Tavora-Jainchill.

After a date night at the movies with her husband turned into a trip to the Emergency Room, Mrs. Tavora-Jainchill spent the next several days consulting with doctors, including internist Eric Last, DO, and obstetrician/gynecologist Susan Scavo, MD, to determine the cause of her excruciating abdominal pain. The initial CT scan administered in a local ER revealed large ovarian neoplasms (abnormal masses of tissue), which indicated the need for surgical intervention. At the recommendation of Dr. Scavo, Mrs. Tavora-Jainchill went to see Dr. Jiménez, who thoroughly reviewed her test results and explained all of the options for surgery.

“Dr. Jiménez explained to me that he could approach the surgery in a minimally invasive way, but if the pathology tests revealed cancer, he would have to perform a more invasive surgery that would leave me out of commission for a very long time,” she said.

Prepared for anything on the day of surgery, Mrs. Tavora-Jainchill remained hopeful that she did not have cancer. When she awoke from surgery, she was pleasantly surprised to learn that the masses of tissue were benign and that Dr. Jiménez was able to remove her fallopian tubes and ovaries using this minimally invasive technique.

“I never imagined that something so complicated could be done in such an easy manner with such little pain and discomfort!” she said.

Mrs. Tavora-Jainchill went home on the same day as the surgery and was feeling back to her normal self within days. Driving back to the doctor’s office to have her bandages removed, Mrs. Tavora-Jainchill reflected on just how thankful and relieved she was.

“I didn’t have cancer and had just endured a very serious surgery with absolutely no pain at all – it was amazing!”

SILS Sleeve Gastrectomy for Weight Loss

For patients who are deemed appropriate candidates, the minimally invasive SILS sleeve gastrectomy can offer a range of benefits. This procedure involves a nickelsize incision in the abdomen through which the bariatric surgeon reduces the size of the stomach. This helps to restrict a patient’s food intake and decrease their appetite. The single incision minimizes trauma to the abdominal wall, resulting in less postoperative pain, a shorter hospital stay and an improved cosmetic outcome. In addition to assisting patients with achieving their weight loss goals, the procedure has been linked to improving health conditions such as type 2 diabetes, high blood pressure, high cholesterol and obstructive sleep apnea.

SILS Cholecystectomy (Gallbladder Removal)

A new, minimally invasive approach to removing the gallbladder – a small, non-vital organ that aids in digestion – SILS cholecystectomy enables Winthrop surgeons to remove an infected or inflamed gallbladder through a single incision for less postoperative pain and a faster recovery
Vol. 22, No. 1
Winter/Spring 2012

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