Dr. Dobson continues to be amongst the forerunners in the adoption of new technology in the field of general surgery and minimally invasive surgery.
Since May 2008, Dr. Dobson has performed over 100 procedures using the Da Vinci HD Robotic system, the most advanced surgical tool available inmeical history! From simple procedures such as cholecystectomy for gallbladder removal, to complex procedures including colon resections, splenectomies, abdominal-perineal resections, and truly anatomic incisional hernia repairs, Dr. Dobson has become a world leader in the adoption of this most advanced tool.
By taking common advanced laparascopic procedures and developing a robotic counterpart has allowed Dr. Dobson to perform highly complex and laparascopically-difficult procedures in less time, with more accuracy, and better visualization, less blood loss, and no complications.
On September 15th, 2008, Dr. Dobson performed the world’s first single incision robotic cholecystectomy. Read below for the story!
ST PETERSBURG, FL — An advanced minimally invasive surgeon trained in Chicago believes he’s made history in the southeastern United States after performing the first robotic gallbladder removal through a single tiny incision made in a patient’s belly button.
The single incision robotic gallbladder surgery , also known as SIRGS, was performed on September 15, by H. Drexel Dobson III MD, FACS, a pioneer in the application of the da Vinci Surgical System to the fields of General and Colorectal Surgery, at St. Petersburg General Hospital, a 219-bed community facility and teaching hospital.
Dr. Dobson and his robotic team performed the entire operation though a 1.45cm incision, roughly ¾ of an inch, made in the navel of his patient. He then removed the gallbladder through the same incision, with no other cuts.
Gallbladder surgery through a laparoscopic approach is the most common procedure performed in US hospitals by general surgeons. It is done through a small incision in the belly button, and two or three more small incisions in the abdomen just below the right rib cage. Over 750,000 gallbladders are removed every year in the US. Since 1999, Dr. Dobson has routinely removed the gallbladder through a total of three small ports, in over 500 gallbladder surgeries. In fact, he has perfected his technique to apply the same limited number of ports to perform other procedures on the liver, spleen, intestines and stomach.
As technology advanced, Dr. Dobson adopted a technique whereby the gallbladder was able to be removed through the single small incision in the belly button, with no other incisions anywhere else. This technique, call single incision or SILS, is in its infancy and is being performed at the leading centers for minimally invasive surgery by a small set of extremely talented surgeons around the world.
Dr. Dobson then took this technique, and modified it slightly for use with the da Vinci High Definition Surgical System, a device which provides the advantages of true 3 dimensional vision and completely articulating instruments (surgical tools which can bend at their wrist) allowed Dr. Dobson to perform the surgery in a safer, more controlled fashion, than standard laparoscopic multiple port or single incision laparoscopic surgery.
The robotic single incision robotic procedure took about 30 minutes longer than the time it would take to complete a standard multiple port laparoscopic gallbladder removal, and only about 20 minutes more than a single incision laparoscopic gallbladder procedure. To compare and contrast the surgical techniques, Dr. Dobson performed a single incision laparoscopic procedure the same day shortly thereafter, another first in the Pinellas area. Both patients went home the same day, and are doing well.
“This equipment provides me and my team better visualization and understanding of the patient’s anatomy, significantly better instrumentation to perform highly delicate and complex dissections with less tissue destruction, and overall less pain and an even faster recovery than that which traditional laparoscopic surgery provides, now with even better cosmetic results,” states Dr. Dobson.
Since St. Petersburg General Hospital’s acquisition of the da Vinci Surgical System earlier this summer, various surgeons in other specialties have performed over forty-five state of the art advanced robotic surgical procedures. Dr. Dobson himself has performed over 23 robotic procedures, from colon resections, gallbladder and biliary surgeries, esophageal hernia repairs, rectal prolapse repairs, and even complex incisional hernia repairs with the robotic system, and multiple tiny incisions. This time however, he was able to roll all these benefits into a single incision smaller than ever before. “Having several small incisions sure is nice, but having an even smaller single incision sure is better,” says Dr. Dobson.
Dr. Dobson has observed that most patients are back to their normal activities of daily life faster than with conventional laparoscopic surgery with the added technological benefits of the robot, with less pain. “One patient had a grapefruit-sized complex incisional hernia which was fixed robotically, and was able to resume normal activities without any pain 48 hours after surgery,” observed Dr. Dobson.
Dr. Dobson was motivated and inspired to try this groundbreaking technique after colleagues at Washington University’s Barnes Jewish Hospital performed the world’s first single incision robotic surgery removing a kidney tumor on August 1st. “Dr. Bhayani and his colleagues were able to accomplish a great feat, removing a kidney through the belly button using a 3 inch incision,” states Dr. Dobson, using a single robotic incision. He goes on to point out that “our incision is less than 1 inch in size, and only a few millimeters longer than the standard incision made to place a regular laparoscopic camera in the belly button, which is almost 2 and a half inches less than the kidney incision from St. Louis.”
“The system allows us to have our hands and eyes inside the body like never before, allowing us to continue our quest to perform better, faster, safer, and more accurate surgery with less scarring, and less chance of infection – it’s the future of surgery ‘s tomorrow, here today” comments Dr. Dobson.
Dr. Dobson has used the da Vinci robot for several firsts, and is the only general and colorectal surgeon in the Central and West Florida area routinely performing safe and successful robotic operations with this state of the art system.
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