Minimally-Invasive Surgery at UHealth

University of Miami Health System specialists often use minimally-invasive procedures as an alternative to traditional open surgery. For the patient, a minimally-invasive surgery, sometimes referred to as ‘keyhole’ surgery, means small surgical scars, less trauma to the body, and often a quick recovery time and shortened hospital stay.

Minimally-invasive surgery is also known as laparoscopic surgery. UHealth surgeons are also able to utilize the daVinci surgical system offering more precision because of better imaging.

Minimally-invasive procedures are performed by many UHealth specialists at our affiliated hospitals and facilities including:

• University of Miami Hospital
• University of Miami Hospital and Clinics
• Sylvester Comprehensive Cancer Center
• Jackson Memorial Hospital 
• Miami VA Medical Center

As part of the University of Miami Miller School of Medicine, UHealth physicians derive great benefit from research and education. The Center of Excellence for Laparoscopic and Minimally Invasive Surgery is a state-of -the-art medical facility located on the University of Miami Miller School of Medicine campus and is a premier facility for education, training, and research and development in laparoscopic and minimally invasive surgery.

The center is committed to teaching surgeons the application of minimally invasive surgical techniques so that they are well equipped to offer an alternative to traditional open surgery. 

Technology

UHealth surgeons use two types of minimally-invasive procedures, laparoscopic and computer-assisted or robotic surgery. Both have advantages over ‘open surgery’ where physicians cut skin and tissue for direct access to the surgical site.

Laparoscopic Surgery

Minimally-invasive, or laparoscopic, surgery is done through small incisions. Using specialized techniques, miniature cameras with microscopes, tiny fiber-optic flashlights and high definition monitors, surgeons in many specialties can perform surgery through an incision that requires only a stitch or two to close.

Robotics

The da Vinci Surgical System is improving patient experiences and outcomes by:

• Simplifying many existing minimally-invasive procedures
• Many surgical procedures performed today using standard laparoscopic technique may be performed more quickly and easily using the da Vinci Surgical System. This is because the da Vinci System delivers increased clinical capability while maintaining the same "look and feel" of open surgery.

A number of procedures that could not be performed using traditional minimally invasive technologies can now be performed using the da Vinci Surgical System. The advanced feature set and extensive EndoWrist® instrumentation of the da Vinci System enable surgeons to perform more procedures through 1-2 cm incisions.

Specialties:

• The Bariatric Surgery Center
• Cardiothoracic Surgery
• Colorectal Surgery
• Endourology
• Gynecology/Gynecological Oncology/Reproductive Medicine/Urogynecology
• Laparoendoscopic Surgery
• Vascular and Endovascular Surgery

Procedures

Bariatric Surgery

The Bariatric Surgery Center’s multidisciplinary team specializes in minimally invasive surgical (laparoscopic) techniques for the treatment of obesity. Our excellent physicians and health care professionals are dedicated to meet your pre-operative and post-operative needs. Laparoscopic bariatric surgery can help you reach your weight loss goal and ultimately lead a healthier active lifestyle with a rapid recovery and healing. 

The following minimally invasive procedures are performed at our center:

• Laparoscopic Roux-en-Y Gastric Bypass
• Laparoscopic Banding
• Laparoscopic revisions and explorations, including hernia repairs

Cardiothoracic Surgery

Cardiothoracic surgery manages the operative, perioperative, and critical care experience of patients with pathologic conditions within the chest. It includes the surgical management of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the great vessels and heart valves, congenital anomalies of the chest and heart; tumors of the mediastinum, diseases of the diaphragm, and management of airway and injuries of the chest.

Physicians in the division are among the world’s leaders in performing the latest procedures and techniques and are always on the cutting-edge of technology. Some of the procedures offered are:

• Beating Heart Coronary Artery Surgery
• Beating Heart Valve Surgery
• Bloodless Surgery
• Atrial Fibrillation Surgery
• Valve Surgery
• Major Aortic Surgery
• Cardiomyopathy
• Assist Devices
• Thoracic Surgery
• Pediatric Cardiac Surgery

Colorectal Surgery

UHealth’s colon and rectal surgery division offers a wide range of minimally invasive colorectal procedures. We have extensive, long-term experience in treating all forms of colorectal disorders laparoscopically.

Currently, we are offering laparoscopic surgery as an option for patients with colorectal polyps and cancer, diverticular disease, prolapse, and inflammatory bowel disease, as well as other less common conditions.

Through our Center for Digestive Disorders and the Sylvester Cancer Center’s site disease group for colorectal cancer, we work hand in hand with a variety of specialists to ensure that our patients get the best, most effective, coordinated care and treatment possible.

Endourology

Over the last decade, the treatment of a variety of urologic diseases has evolved significantly. Treatment of stones, renal obstruction, and a variety of other genitourinary disorders with endoscopes and other minimally invasive techniques, such as extracorporeal shock-wave lithotripsy and fiberoptic endoscopy, is now commonly referred to as endourology.

This field has expanded with the advent of laparoscopy, which refers to minimally invasive surgery performed through small incisions (with the use of a camera and specialized instruments) on a variety of genitourinary body structures, including the kidneys, ureter, bladder, and prostate. Urologic laparoscopists also specialize in laparoscopic surgery of the adrenal gland.

Some of the procedures offered are:

• Caliceal diverticulectomy
• Complex stones of the kidney or urinary bladder
• Cyst decortication
• Donor nephrectomy (transplant)
• Nephroureterectomy
• Partial nephrectomy
• Prostatectomy (with and without the daVinci robot)
• Pyeloplasty (with and without the daVinci robot)
• Radical nephrectomy
• Radiofrequency ablation
• Ureteral reimplantation
• Ureteral stricture treatment

Gynecology, Gynecological Oncology, Reproductive Medicine, Urogynecology

These divisions within UHealth’s Obstetrics/Gynecology are well regarded for their expertise in the latest technologies for the treatment of women’s health problems such as uterine fibroids, endometriosis, pelvic relaxation, infertility, urinary incontinence, family planning, and gynecological malignancies. Our doctors have a special interest in the minimally invasive surgical management of these disorders.

The following minimally invasive procedures are performed by our division:

• Diagnostic laparoscopy
• Laparoscopic management of endometriosis
• Laparoscopic tubal surgery
• Laparoscopic removal of tubes/ovaries
• Laparoscopic sterilization
• Laparoscopic myomectomy
• Laparoscopic vaginal hysterectomy
• Laparoscopic hysterectomy
• Laparoscopic supracervical hysterectomy
• Laparoscopic radical hysterectomy
• Laparoscopic lymph node dissection
• Diagnostic hysteroscopy
• Hysteroscopic sterilization
• Hysteroscopic polypectomy
• Hysteroscopic myomectomy
• Hysteroscopic endometrial ablation
• Minimally invasive sling procedures for urinary incontinence (TVT, TVT-O)
• Laparoscopic procedures for pelvic organ prolapse
• Minimally invasive vaginal procedures for pelvic organ prolapse with or without mesh

Laparoendoscopic Surgery

Through continual research and training, highly-skilled UHealth physicians in the Laparoendoscopic Surgery Division stay abreast of advances in minimally invasive surgery to ensure patients receive the most advanced treatment. Our surgeons also train physicians in the community and worldwide in these advanced techniques.

Almost all abdominal surgeries can now be performed using a minimally invasive approach. Laparoscopic surgeries performed by the surgeons in our division include:

• Anti-reflux surgery for heartburn
• Hiatal hernia repair
• Inguinal hernia repair
• Incisional hernia repair
• Gallbladder removal
• Appendectomy
• Solid organ removal (kidney, spleen, adrenal gland, pancreas)
• Abdominal exploration for cancer
• Colon surgery

Flexible endoscopic procedures include:

• Upper endoscopy for evaluation of the esophagus, stomach, and intestine
• Colonoscopy
• Endoscopic antireflux procedures to treat heartburn
• ERCP (endoscopic retrograde cholagiopancreatography) to evaluate and treat the bile and pancreatic ducts

Vascular and Endovascular Surgery

The Division of Vascular and Endovascular Surgery offers the entire array of vascular procedures ranging from state-of-the-art endovascular aneurysm repair in the thoracic and abdominal aorta to angiogenesis, an evolving modality to treat critical blood flow. Balloon angioplasty, stent and stent-graft placement, thrombolysis, ultrasound directed intervention, and venous ablation with ultrasound or laser are some of the other minimally invasive technologies commonly performed.

The uniqueness of the division stems from the broad training of each of its members in vascular surgery as well as in interventional catheter based techniques. This provides the patient with therapeutic decisions not limited by a narrow perspective.

Operations and surgical procedures performed include:

• Carotid endarterectomy and carotid stent placement
• Vertebral artery reconstruction
• Subclavian, axillary, and brachial artery reconstruction
• Arch aneurysm stent graft (endovascular) repair
• Branch arch vessel reconstruction
• Thoracic aortic aneurysm repair (surgery or stent graft)
• Thoracoabdominal aortic aneurysm repair
• Renal artery revascularization by surgery or stent
• Visceral artery bypass
• Suprarenal aortic aneurysm repair
• Infrarenal aortic aneurysm repair (surgery or stent graft) 
• Iliac artery aneurysm repair (surgery or stent graft)
• Iliac artery bypass or endovascular repair
• Lower extremity revascularization
• Balloon angioplasty of appropriate vessels
• Thoracic outlet surgery
• Lymphedema surgery
• Sub-fascial endoscopic perforator surgery for venous insufficiency
• Dialysis access surgery
• Treatment of gangrene
• Varicose vein procedures
• Trauma surgery
• Temporal artery bypass surgery
• Arteriovenous malformation surgery

 

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