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state-of-the-art robotic and laparosopic surgery

Da Vinci

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Robotic and Laparoscopic Surgery

Laparoscopy utilizes a set of linear instruments that the surgeon directly controls at the operation table. Robotic surgery is the augmentation of laparoscopy with the aid of an elegant machine, which allows the surgeon to operate in three-dimensional vision and with unparalleled dexterity via a console adjacent to the operating table.

da VinciThis machine named da Vinci (Intuitive Surgical, Inc.) allows the surgeon to perform advanced operations beyond the reach of standard laparoscopy. The most common robotic procedures performed by urologists are robotic radical prostatectomy and robotic pyeloplasty. There is an abundance of evidence illustrating that men who undergo robotic prostatectomy for prostate cancer have less blood loss, less pain, shorter hospital stays, faster recovery and return to work. The continence, potency and cancer control rates are equal or superior to the traditional open radical prostatectomy. Similar to standard laparoscopy, your urologist will determine if robotic approach is indicated for your particular disease. 

Dr. J. James Bruno II

Having trained at Lenox Hill Hospital, Cornell University/New York Hospital and Memorial-Sloan Kettering Cancer Center, Dr. Bruno offers his patients laparoscopic, robotic and other minimally invasive techniques. Specifically, he performs:

  • Laparoscopic radical nephrectomy           
  • Laparoscopic partial nephrectomy
  • Laparoscopic renal cryoablation
  • Laparoscopic lymph node dissection
  • Laparoscopic/robotic pyeloplasty
  • Robotic radical prostatectomy


Traditionally, abdominal or pelvic surgery has been performed  via an open incision, also referred to as a “laparotomy.”  This approach uses large incisions that cut through skin, fatty tissue, muscle, fascia, and sometimes bone to access the target organ.  Although this technique accomplishes the intended goal of removing (or repairing) the affected organ, it does so at a cost — post-operative recovery.

“Laparoscopy” is defined as a minimally invasive technique to look inside the abdomen or pelvis with specialized camera or scopes. The scopes and instruments are placed through the abdominal wall via several small (less than ½ inch) incisions.  Laparoscopic surgery inflates the abdomen with gas to create a working space in order to remove or repair the affected organ.

da VinciThe advantage of laparoscopy over traditional open technique is the ability to accomplish the same surgical goal with less pain, less blood loss, a shorter hospital stay and often better outcomes due to improved vision and precision. Typically, laparoscopic procedures require significantly less narcotic requirement and patients go home 1 or 2 days after surgery with small Band-Aids rather than large incisions.

In Urology, the most commonly treated organs with the laparoscopic approach are the kidneys and the prostate. The removal of the whole kidney (laparoscopic radical nephrectomy) or part of the kidney (laparoscopic partial nephrectomy) can both be accomplished by laparoscopy in cases of kidney tumors. Similarly, the prostate can be excised (radical prostatectomy) via a laparoscopic technique for prostate cancer. Other urological diseases  can also be treated via the laparoscopic approach.

Although laparoscopy is a “minimally-invasive” modality, it is still surgery and there are potential risks and complications.  Furthermore, laparoscopy has become a standard of care for many types of procedures but these are cases in which laparoscopy is not appropriate and traditional open procedure is favored. Your urologist will determine this based on many pre-operative factors such as the extent of your disease and any prior abdominal surgery.

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