Single-Site* Gallbladder Surgery: Helping Patients Heal Faster

If you have a gallbladder attack or severe symptoms, your doctor will likely suggest surgery to remove your gallbladder, a pear-shaped organ that sits just below your liver on the upper right side of your abdomen. While this organ is part of the digestive system, it is one which you can live without. The surgery for gallbladder removal is known as a cholecystectomy.

Cholecystectomy is a common surgery, and it carries only a small risk of complications. In most cases, you can go home the same day of your procedure.

Conservative treatments, such as dietary modifications, unfortunately, usually can’t stop gallstones from recurring or causing pain and other digestive problems. Surgery is often the best or only option to relieve the discomfort of gallbladder disease. A cholecystectomy can relieve the sometimes-severe pain of gallstones.  

Gallbladder surgery can be done using open surgery (through one large incision) or minimally invasively (through a few small incisions or one belly button incision) using da Vinci Surgery or traditional laparoscopy. Most people who require gallbladder removal are candidates for the robotic, single-incision surgery. 

In some cases, one large incision may be used to remove the gallbladder. This is called an open cholecystectomy.

Present-day cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. Doctors call this a laparoscopic cholecystectomy. 

Surgeons using da Vinci technology can remove your gallbladder through one small incision in your belly button using Single-Site* technology, or through a few small incisions. The da Vinci System is a robotic-assisted surgical device of which your surgeon is always in 100% control. 

With the da Vinci System surgeons get:

  • A 3D HD view inside your body
  • Special wristed instruments that bend and rotate far greater than the human hand
  • Enhanced vision, precision, and control

Benefits of laparoscopic cholecystectomy can include:

  • minimal scarring
  • less pain
  • less bleeding
  • faster recovery
  • shorter hospital stays

A cholecystectomy is most commonly performed to treat gallstones and the complications they cause. Your doctor may recommend a cholecystectomy if you have:

  • Gallstones in the gallbladder (cholelithiasis)
  • Gallstones in the bile duct (choledocholithiasis)
  • Gallbladder inflammation (cholecystitis)
  • Pancreas inflammation (pancreatitis) due to gallstones

If pain from gallstones or cholecystitis are disrupting your life, schedule a consultation at VIPSurg. Dr. Tsuda and his team can determine the best method for treating your condition. Robotic surgery can get you home and back to doing what you love — quickly and with minimal pain! Call for an appointment at (702) 487-6000. 

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Plastic Surgery After Dramatic Weight Loss

Weight loss whether through bariatric surgery or diet and exercise is truly a life changing event and a major achievement. You look and feel better and are healthier. And while most of the changes that accompany weight loss are positive, loose skin is a concern for many patients. Hanging skin can affect both comfort and self-confidence and can be a daily reminder of past obesity. 

Unfortunately, when skin has been stretched around the abdomen, arms, legs, breasts, and face, it may lose its elasticity. After significant weight loss, the skin often fails to shrink back to its former size and shape. How much this loose, saggy skin affects personal appearance can depend on age, genetics, exercise, speed of weight loss, and smoking, according to the American Society for Metabolic and Bariatric Surgery (ASMBS).

The areas of the body that most often are affected by excess skin include:

  • Abdomen
  • Breasts
  • Buttocks
  • Face
  • Groin
  • Thighs
  • Neck
  • Upper arms

For some people, weight loss might be gradual enough that skin adjusts along with weight loss. For others, the loose skin can be hidden with clothing and compression garments. But when that isn’t enough to manage the problem, plastic surgery might be a logical next step.

The best time to consider plastic surgery in when you are as close to your goal weight as possible and are weight stable. Surgeons often recommend waiting at least 18 months before having surgery to remove or reduce excess skin because the more weight you lose, the more excess or saggy skin you could have.

 The goal of plastic surgery after dramatic weight loss is to restore attractive proportions by removing the sagging skin that creates a misshapen contour. Although these procedures leave scars, most patients find them to be an acceptable tradeoff for an improved appearance.

As with all major decisions, it’s always advisable to consider the positives and negatives:

Pros

  • Gets rid of loose skin so you can fit into your clothes better.
  • Gets rid of overhanging skin that might be causing painful chafing, rashes, and infections.
  • Improves your self-esteem.

Cons

  • Surgery results may not meet your expectations.
  • You will have permanent scarring.
  • Your surgery results may be affected by weight gain, aging, and lifestyle choices.

If you are considering plastic surgery to improve your body contour, these characteristics make you a good candidate:

  • Your weight has been stable for at least six months with no further weight loss expected. 
  • You are in overall good health without chronic medical conditions, such as diabetes or heart disease. 
  • You have a healthy diet; problems such as protein deficiencies can interfere with healing.
  • You do not smoke; smoking slows down the healing process and increases the risk of serious complications during and after surgery. If you smoke, you must quit at least six weeks before surgery.
  • You have mental stamina; surgical contouring procedures require patience and endurance.
  • You have realistic expectations; surgery will lead to marked improvements in your shape, but it is impossible to restore the skin or body to what it would have been without the weight gain. Even after body-contouring surgery, skin continues to sag over time as part of normal aging.

If you are considering bariatric surgery in the Las Vegas area, schedule a consultation at VIPSurg. Our doctors and expert team can help you find the right treatment for your unique situation.

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Benefits of Robotic Surgery

Technology is changing the way we do practically everything now, and the medical world isn’t immune. The da Vinci robot is changing the way surgeons are performing operations and is providing benefits to both patients and doctors.

While the surgeon sits at a modified computer console, he/she can control the instruments and camera. Placing their fingers into the master controls, the surgeon operates the arms of the da Vinci robot while simultaneously looking through a stereoscopic high-definition monitor that gives a better, more detailed 3-D view of the operating site than the human eye can provide. Every movement he makes with the master controls is replicated precisely by the robot. The robot’s “hands” have a high degree of dexterity, allowing surgeons the ability to operate in very tight spaces in the body that would otherwise only be accessible through open (long incision) surgery.

Using the da Vinci robot allows surgeons to perform a growing number of surgical procedures. Since these surgeries can be done through very small incisions, patients experience many benefits compared to open surgery, including:

  • Less trauma on the body
  • Shorter hospitalization
  • Reduced pain and discomfort
  • Faster recovery time and return to normal activities
  • Smaller incisions, resulting in reduced risk of infection
  • Reduced blood loss and transfusions
  • Minimal scarring

The surgical team supervises the robot at the patient’s bedside. Unlike traditional surgery where the surgeon stands over the patient sometimes for hours, a surgeon using the da Vinci system is seated, substantially decreasing surgeon fatigue. Add in the greater visualization abilities, enhanced dexterity, and greater precision and there are major advantages for both patients and surgeons using robotic surgery alike.

Dr. Tsuda and Dr. Ryan at VIPSurg are expert robotic surgeons. Call 702-487-6000 to schedule a consultation.

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5 Common Signs and Symptoms of a Hernia

Hernias are caused when fatty tissue or internal organs squeeze through weak muscle walls and connective tissue. A hernia can occur in any part of the body, but the most common areas are the inner groin (inguinal hernia), outer groin (femoral hernia), near the navel (umbilical hernia), upper abdomen (hiatal hernia), or at the site of a recent surgical scar (incisional hernia) They can be mildly to extremely painful, and they sometimes go away when you press on them or lie down. They are aggravated by coughing or sneezing. If a hernia doesn’t resolve itself, you may require surgery.

Here are 5 common signs and symptoms of a hernia:

  1. Visible Lump – often the first indication of a hernia is a visible lump or bulge which left untreated becomes very painful as more tissue is forced through the opening, widening and splitting the muscle, forming a large sac. Sometimes patients notice the bulge before the pain, but often there’s pain before the lump is noticeable to the naked eye.

**It’s very important that you go to your doctor as soon as you notice a lump anywhere as it may signify another health issue.

  1. Pain — ranging from slightly uncomfortable to severely painful, patients report everything from just seeing the bulge with no pain to excruciating pain that cannot be ignored
  2. A Full Feeling — A heavy, bloated, or uncomfortable feeling in your gut is common to those with umbilical or hiatal hernias. A feeling often described as a dragging sensation in the groin may be an inguinal hernia.
  3. Stomach Upset — including indigestion, nausea, and bowel issues may occur with hernias located in the groin or abdominal areas. If a hernia becomes strangulated (or blood supply is cut off), you will experience nausea and vomiting. A strangulated hernia requires immediate emergency medical attention as it is life-threatening to the patient.
  4. Difficulty with Daily Activities — as hernias grow and pain worsens, the quality of your daily life is affected. When common activities such as work, picking up children, and exercise become difficult and uncomfortable, hernia-repair surgery is often the answer.

At VIPSurg, our surgeons are experts in hernia repair using minimally invasive daVinci robotic surgery. Schedule a consultation to learn more.

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Tips for Finding the Right Surgeon for You

Almost any surgery can cause serious complications, so you always want to be in good surgical hands. With so many doctors, how do you know which is the right surgeon for you?

One indicator to note is how often surgeons perform a procedure. That can be vital for operations that are relatively new, such as gastric bypass surgery for treating obesity. While many surgeons have started performing the operation, not all are qualified. A September 2009 study found that the risk of serious complications from the most common form of gastric bypass surgery fell by 10 percent for every additional 10 cases per year the surgeon had performed.

However, quantity isn’t the only or even most important measure of quality. A May 2009 study of 81,289 adults who had heart bypass surgery, for example, found that success depended more on how well surgeons and hospitals adhered to various markers of surgical excellence—such as using the appropriate technique during the operation and prescribing the right medications before and afterward—than the number of procedures performed.

Don’t be afraid to question your doctor. Ask your prospective surgeon these questions before going under the knife:

  • Is surgery really necessary? The best way to avoid surgical errors is to avoid surgery entirely, so ask about the effectiveness and safety of alternatives. Compare those with the risks of surgery and the chance that it will help you.
  • Is your board certification up to date? Look for a surgeon who has undergone the necessary training, even after being in clinical practice, to maintain board certification in his or her specialty.
  • What’s your experience? Ask how many operations the surgeon has performed in the past year and how that compares with his or her peers. You don’t have to find the busiest, most experienced surgeon in North America, but it’s important to avoid the doctor who does very few of the procedures, especially in a place that does very few.
  • What are your success, failure, and complication rates? Not all will be able or willing to tell you, but the good ones should be.
  • What’s the hospital’s infection rate? Seventeen states now make that information public, and many hospitals report their rates voluntarily.

doctor-650534_960_720Just remember to worry less about bedside manner and more about the final outcome. If you have to choose between a nice surgeon and a highly skilled surgeon, the skilled surgeon is the better bet.

If you live in the Las Vegas area and are looking for a surgeon who is both compassionate and highly skilled, Dr. Tsuda at VIP Surg is everything you’re searching for. Whether you have general surgery needs or are interested in bariatric surgery, he and his team of experts have the experience and skill for you to have an excellent outcome.

Gallbladder Disease and Gallstones

Some people think of their gallbladder as being “expendable”. Not that anybody wants any of their organs to be removed, but since many people live a seemingly normal life after getting their gallbladder removed, many people don’t think their gallbladder plays an important role in their overall health. After all, how important can your gallbladder be if you can do just fine after it’s surgically removed? The gallbladder actually plays a very important role in your body. It is an essential part of the digestive system.

Your gallbladder is most likely to give you trouble if something blocks the flow of bile through the bile ducts. That is usually a gallstone. Gallstones form when substances in bile harden. Rarely, you can also get cancer in your gallbladder. Many gallbladder problems get better with removal of the gallbladder. Fortunately, you can live without a gallbladder. Bile has other ways of reaching your small intestine.

In the United States, about a million new cases of gallstone disease are diagnosed each year, and some 800,000 operations are performed to treat gallstones, making it the most common gastrointestinal disorder requiring hospitalization.

Gallstone disease is the most common disorder affecting the body’s biliary system, the network of organs and ducts that create, transport, store, and release bile. Bile contains cholesterol, water, proteins, bilirubin (a breakdown product from blood cells), bile salts (the chemicals necessary to digest fat), and small amounts of copper or other materials. If the chemical balance of bile contains too much of any of these components, particularly of cholesterol, crystals form and can harden into stones.

In terms of size, gallstones can be as small as a grain of sand or as large as a golf ball. A person can form one large stone in his or her gallbladder, or hundreds! About 10 percent of the population has gallstones, but the vast majority experiences no symptoms and need no treatment. However, in 1 percent to 2 percent of these people, gallstones can cause problems by lodging in bile ducts, stopping the flow of bile or digestive enzymes, and leading to severe abdominal pain, vomiting, inflammation, and even life-threatening infection.

Gallstone attack has some classic symptoms: The most agonizing pain is experienced in the upper right part of the abdomen under the ribs. Usually it appears suddenly, sometimes an hour or two after eating a fatty meal. The pain may get worse quickly, and then last for several hours. Many times, the pain may radiate to the back between the shoulder blades or under the right shoulder. Inhaling deeply, or moving, often makes the pain worse. The primary therapy for gallstones that are causing pain, inflammation, or infection is removal of the gallbladder.

A number of factors put people at higher risk of gallstones:

  • Gender: Women between the ages of 20 and 60 are 3 times more likely to develop gallstones than are men in the same age group. By age 60, 20 percent of American women have gallstones.
  • Age: The incidence of gallstone disease increases with age.Tsuda 11-18
  • Genetics: Family history and ethnicity are critical risk factors in development of gallstones, though no gene responsible for gallstone formation has yet been discovered. African-Americans seem to have lower rates of gallstone disease than American Indians, whites, or Hispanics.
  • Obesity: Obesity is a significant risk factor, particularly for women. Obesity also slows down the emptying of the gallbladder.
  • Location of body fat: Belly fat, that spare tire around the middle, dramatically increases the chance of developing stones.
  • Diabetes: People with diabetes often have high levels of triglycerides in their blood, and these fatty acids tend to increase the risk of gallstones.

Even if you’re not at risk for gallstones, it is wise to maintain a healthy body weight, by among other things, sticking to a diet that is low in fat and cholesterol and high in fiber.

If you are in the Las Vegas area and suffering with gallstones or gallbladder disease, schedule a consultation at VIP Surg.

Robotic Surgery Explained

Screen Shot 2017-10-10 at 12.35.38 PMRobotic surgery is a type of minimally invasive surgery. “Minimally invasive” means that instead of operating on patients through large incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch incisions. When performing surgery with the da Vinci Si—the world’s most advanced surgical robot—these miniaturized instruments are mounted on three separate robotic arms, allowing the surgeon maximum range of motion and precision. The da Vinci’s fourth arm contains a magnified high-definition 3-D camera that guides the surgeon during the procedure.

The surgeon controls these instruments and the camera from a console located in the operating room. Placing his fingers into the master controls, he is able to operate all four arms of the da Vinci simultaneously while looking through a stereoscopic high-definition monitor that literally places him inside the patient, giving him a better, more detailed 3-D view of the operating site than the human eye can provide. Every movement he makes with the master controls is replicated precisely by the robot. When necessary, the surgeon can even change the scale of the robot’s movements: If he selects a three-to-one scale, the tip of the robot’s arm will move just one inch for every three inches the surgeon’s hand moves. And because of the console’s design, the surgeon’s eyes and hands are always perfectly aligned with his view of the surgical site, minimizing surgeon fatigue.

The ultimate effect is to give the surgeon unprecedented control in a minimally invasive environment. Utilizing this advanced technology, surgeons are able to perform a growing number of complex surgical procedures. Since these procedures can now be performed through very small incisions, patients experience a number of benefits compared to open surgery, including:

  • Less trauma on the body
  • Minimal scarring
  • Faster recovery times

If you’re facing general or bariatric surgery in the Las Vegas area, contact VIP SURG to learn about how we can help. Drs. Tsuda and Ryan specialize in minimally invasive procedures and are experts in robotic surgery. Call for a consultation at 702-487-6000.