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.