Surgery Team and Advanced Techniques
Every operation is performed with high quality by a multifaceted team of experts who take pride in the delivery of safe, efficient, and technically precise surgeries. The team includes surgeons, anesthesiologists, nurses, and surgical techs, who are all perfectionists in their roles creating a synergy that affords the best surgical results. If a procedure can not be completed with advanced techniques or with fewer incisions, traditional laparoscopic surgery will become the default. Every minimally invasive operation carries a risk for conversion to an open procedure, and the surgery team will be ready to convert if it is necessary.
More than 95% of cases performed by Dr. Scott Mimms are completed using a minimally invasive technique. This basically means that small incisions are used instead of the long midline incision that was previously used for abdominal surgeries. Trocars are inserted through the incisions, traversing the full thickness of the abdominal wall allowing access from outside of the body to the inside of the body. Instruments and lighted cameras are inserted through the trocars to facilitate visualization and manipulation of the organs as needed for the intended surgery. It is standard for most abdominal surgeries to be performed with a minimally invasive technique called laparoscopic surgery. The advantages of laparoscopic surgery include decreased pain, improved deep breathing, prevention of post-operative fever and pneumonia, improved complications from the incisions, and decreased length of stay in the hospital. The picture by Stryker demonstrates the placement of the trocars for a typical Laparoscopic Cholecystectomy.
Da Vinci Advanced Technique
The use of the da Vinci Si system by Intuitive Surgical provides an advanced surgical technique because it restores open surgical principles to minimally invasive surgery by offering the surgeon superior visualization, precision, and ergonomics. Nationally, the da Vinci technology is allowing surgeons to dramatically reduce the rate of conversion to open surgery and improve clinical outcomes, creating a new standard of care. By virtue of its 3D HD vision, wristed instrumentation and precise intuitive movement, even the most challenging and complex surgical candidates (i.e overweight patients with high BMIs) can expect minimally invasive surgery. Dr. Mimms uses the da Vinci Si for a majority of both bariatric and general surgeries.
There is a paradigm shift towards doing surgeries with one incision that can be hidden in the umbilicus (belly button). The gallbladder can be removed (cholecystectomy) with one incision. This operation was attempted laparoscopically, but it can be rather cumbersome. The da Vinci Si provides the aforementioned 3D HD view and allows for triangulation of tissues, making dissection much safer and less cumbersome than prior single site approaches. The FDA has recently approved single incision robotic assisted cholecystectomy. Dr. Mimms is one of the first surgeons in the state of Indiana to offer this advanced technology. Just as laparoscopic cholecystectomy improved patient outcomes, robotic single incision surgery will take this surgery to the next level.
Some surgeries can now be done with no incisions at all. Operations performed without incisions can be accomplished by access through the mouth. A common operation for GERD or Reflux, called a gastric fundoplication, used to be done as an open operation, but it is now done laparoscopically. Dr. Mimms will either use the da Vinci Si system or he can do the operation with no incisions by using an endoscope that is introduced through the mouth. The operation is called a totally incisionless fundoplication (TIF). Patients must meet certain criteria to qualify for this procedure. Dr. Mimms will determine and discuss eligibility during the surgical consult. Watch the YouTube video by Endogastric Solutions to better understand the procedure.