Single-Incision Gallbladder Removal at Valley Health

Staying fit is a major priority for Elizabeth Ross. This active 24-year-old loves weight-lifting work-outs – and plans to enlist in the US Air Force in 2019. But when she faced gallbladder surgery after a painful gallbladder attack, she worried it would keep her on the sidelines.

It didn’t.

On Valentine’s Day of 2019, Ross became the first Valley Health patient to have her gallbladder removed through a minimally-invasive, single-incision robotic procedure called single site cholecystectomy. Her surgeon, Jorge Posadas, MD, of Valley Health Winchester Surgical Clinic, performed the surgery using Winchester Medical Center’s state-of-the-art robotic da Vinci® Xi™ Surgical System. “Our team removed Elizabeth’s gallbladder through one tiny incision,” says Dr. Posadas. “This meant less pain, a quicker recovery than traditional open surgery or laparoscopic surgery, and one nearly invisible scar.”

An Advanced Option for a Common Surgery

Your gallbladder is a pear-shaped sac that stores bile for digesting fats. But if gallstones form, you can experience painful attacks, inflammation and infection. Removing it – a procedure called cholecystectomy -- is one of the most common surgeries in the US. (“You don’t really need your gallbladder,” Posadas explains. Your liver also sends bile directly to your intestines.)

Most cholecystectomies are performed laparoscopically with a video camera, lights and tools inserted through four incisions in the abdomen. In 2018, Dr. Posadas began preparing to offer an exciting, advanced option at Valley Health: Robotic single-site cholecystectomy.

It was a natural step. Valley Health already offers a wide range of minimally invasive surgical procedures, including robotic options. And Dr. Posadas, who has extensive training in minimally invasive techniques, had worked at length with Winchester Medical Center’s latest-generation da Vinci® Xi™ Surgical System for hernia surgeries prior to preparing to offer the robotic single-site cholecystectomy treatment option.

“The da Vinci System instruments have a high degree of articulation, including 360-degree rotation, so there’s a lot of control and freedom of movement. We also have optimal visualization – I have a magnified, full-color, three-dimensional view of the surgical site. I can zoom in for an even closer look. There’s great depth perception. That means safer, faster surgery.”

Dr. Posadas underwent additional training – including travelling to Methodist Hospital in San Antonio, TX, to observe several procedures with an experienced single site robotic surgeon—before the first robotic gallbladder procedure. “The operating room nurses, scrub nurses, first assistant in robotics and the anesthesia team at Winchester Medical Center all learned about it, too,” he says. “We did a lot of dry runs. We talked about it a lot. We have a skilled and dedicated team in robotic surgery. The program’s success is because of them.”

A First, Then Back to Real Life

Elizabeth’s Valley Health gastroenterologist referred her to Dr. Posadas for a consultation about her gallbladder. Tests suggested it might not be functioning well. And she had a strong family history of gallbladder problems. Five close relatives, including her mother, had had theirs removed. He recommended single-site surgery. With her family’s support, she agreed.

The day of the surgery, her mom drove her to the hospital mid-morning. The procedure began at about 12:30. “I woke up at about 3 pm, the nurses kept checking my pain levels and I went home at about 5 pm,” she says. “There wasn’t much pain at all, I only needed some ibuprofen.”

She barely skipped a beat in her busy life. “I started driving in four or five days and was back at my job at TJ Maxx in a week,” she says. “I felt great. In two weeks I was walking on the treadmill and riding the exercise bike at the gym. Two weeks after that, I was cleared by Dr. Posadas to start lifting weights again.”

Her surgical scar – just 1 ½ inches long and located at the lower curve of her navel – is nearly invisible. “Everyone wants to take a look,” she says, “but there’s not much to see!”

To learn more about Minimally Invasive Surgery at Valley Health, click here.