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When it comes to gallbladder surgery, minimally invasive techniques are commonly used – making the procedure safer and the recovery quicker than ever before. Now, thanks to advancing technologies, some gallbladder surgeries can be performed with only one incision! 

Single site robotic cholecystectomy is a minimally invasive robotic gallbladder removal where the surgeon operates through a single entry point on the body, a person’s navel. It’s a virtually scar-less procedure where the surgeon is in complete control and translates his or her movements in to smaller, more precise movements of tiny instruments inside your body. 

Rather than the four to five small incisions used in a traditional laparoscopic approach, single site robotic surgery is considered the most non-invasive option for gallbladder removal. The results of the procedures are identical to traditional laparoscopic gallbladder surgery, except there’s only one incision. 

“Gallbladder surgery used to be an open procedure, which required a longer recovery. We then moved to laparoscopic surgery and to some degree robotic surgery, both through four or five incisions,” says Jacob Dowden, MD, Hepatopancreatobiliary (HPB) surgeon with University Surgical Associates, who is now performing robotic single incisions surgeries. “It’s exciting that single site robotic surgery offers certain patients a gallbladder removal with virtually no visible scarring whatsoever.” 

In traditional laparoscopy, four incisions are made in the abdomen. Surgical instruments are passed through those incisions, allowing the surgeon to remove the gallbladder. In single site robotic gallbladder removal, all the instruments are passed through one small incision about one inch in size, and the surgeon has a 3D high definition camera inside your body and can operate with extremely precise movements. In most cases, there’s little to no evidence of a scar when the incision heals. 

Key Benefits of Single Site Robotic Surgery 
There are distinct benefits for those who qualify for single site robotic surgery, including: 

*Fewer incisions – typically this surgery requires only one incision in a person’s belly button.
*Potentially faster recovery – with only one incision to heal, recovery times may be shortened.

*Better cosmetic outcome – fewer incisions mean fewer scars. 

Like other outpatient minimally invasive surgeries, most people who have robotic surgery experience no complications and are discharged from the hospital on the same day. According to Dr. Dowden, single site robotic surgery for gallbladder removal is another important step in the evolution of minimally invasive general surgery. But it’s important to understand that this technique isn’t for every patient.

“Single site robotic surgery isn’t appropriate for emergency gallbladder removal, or when the gallbladder is highly inflamed. It’s best reserved for a planned, outpatient procedure to address chronic gallbladder issues.” says Dr. Dowden. “I talk through all the options with my patients to determine the surgical approach that is best for each individual and also both safe and effective.” 

As the technique of single site robotic surgery continues to be refined, surgeons may be able to perform other operations using this advanced approach. The surgeons at University Surgical are highly trained and stay current with the latest technology and techniques to provide the most effective surgeries possible. When you choose USA, you can be confident that you’re receiving the safest and most up-to-date treatment options for your condition. 

For more information or to schedule an appointment, call (423) 267-0466. 

Posted by University Surgical  | Category: gallbladder surgery

Could I have varicose veins?

February 20th, 2018

More Than Cosmetic
Bulging, unsightly veins in your legs are something no one wants to experience - but more than just being embarrassing, varicose veins can signal a more serious health condition. More than 30 million Americans suffer from varicose veins, or the more serious form of venous disease called chronic venous insufficiency (CVI), yet the majority remain undiagnosed and untreated.

"If left untreated, varicose veins can progress to CVI, which can cause pain, swelling and fatigue of the legs, as well as skin damage and ulcers in more severe cases," says Michael Greer, MD , vascular surgeon with the Vein Center at University Surgical Associates. "With varicose veins, the valves that push blood from the legs back to the heart no longer function, causing blood to pool in the legs."

What Puts Me at Risk?
There are several factors that may contribute to varicose and spider veins including puberty, pregnancy, menopause, use of birth control pills and hormone replacement therapy. Aging, standing or working on your feet, obesity and leg injury may also lead to the condition.

Most varicose and spider veins appear because of pressure on the body, making the job of carrying blood from the bottom of the body to the heart more difficult. The veins in the leg endure the most pressure. It's very common for women to develop varicose veins during pregnancy. Changes in hormones and blood volume can cause veins to enlarge, in addition to the extra weight. Some women see improvement after delivery, but women who have multiple pregnancies may have veins that don't go back to normal.

Fast, Effective Treatment
The Vein Center at University Surgical Associates specializes in treating all aspects of vein disease - from tiny spider veins to large bulging varicose veins and pelvic vein insufficiency. Our innovative, nonsurgical approaches include radiofrequency ablation and endovenous laser therapy to effectively treat varicose veins and pelvic vein insufficiency. Sclerotherapy is often utilized in treatment of spider veins. 

"Because the valves in the legs can't be repaired, the only alternative is to re-route the blood flow from the disease veins to healthy veins. Using ultra-sound guidance, a catheter delivers consistent and uniform heat that causes the vein wall to collapse and close," says Dr. Greer. "The treated vein then gradually is absorbed into the surrounding tissue. Most patients report a noticeable improvement in their symptoms within one to two weeks."

What's more, we can effectively pinpoint and diagnose vein problems using ultrasound technology in the Vein Center's onsite vascular lab. It is important to know that not everyone with an abnormal test needs a procedure. Experience and training are necessary to determine who will benefit from a vein procedure.

A Comfortable Experience
At the Vein Center at USA, highly trained and experienced vein specialists conduct all procedures. Most procedures take approximately 60 minutes and are generally offered with the option of conscious sedation, a combination of a sedative and pain blocking medication administered through an IV. Conscious sedation is designed to help patients relax - many even sleep throughout the procedure - yet it wears off quickly and doesn't leave patients feeling groggy. Many patients also experience a quick return to normal activities following a vein procedure, typically within a few days. 

First step - vein evaluation.  

Come to our free vein screening on Tuesday, 2/27 from 5-7pm and we'll evaluate your legs for varicose and spider veins. It only takes a few minutes and it's completely free! All we ask is that you reserve your spot. 

Click here to complete the reservation form or call us during business hours at 423-267-0466.

Posted by University Surgical | Topic: Ask a Doc

Finding Exercise Inspiration

January 31st, 2018

It’s the last day of January! Can you believe the first month of the year is almost over? As quickly as January has come and gone, so have many people’s resolutions to lose weight and get in shape. We get it. It’s not easy to find time to fit in exercise, especially when the skies are gray and the days are short. But exercise – even in small doses – can have a huge impact on your mental, physical and emotional health. 

If you need a pick me up or motivation to head to the gym or go for a walk after work, here are some great reasons to find time for exercise today!

Boosts Your Energy.

Exercise has been known to increase energy levels, and moving regularly can change your perspective on the day. You don’t have to go for a 30-minute run to feel this natural lift in your energy. Use the stairs instead of the elevator, go for a walk on your lunch break, or play tag with your kids in the yard for 15 minutes when you get home. These little bursts of exercise will help get your blood pumping! 

Improves your posture and confidence.

When you exercise regularly, your core gets stronger. And a strong core helps you stand and sit up straighter. People with good posture are perceived as more competent and outgoing. If you’re standing up straight, you’re also likely feel more confident, too. Another added benefit? Strengthening your core has been shown to reduce lower back pain. Yes!


Stress and anxiety are a normal part of life. But when your mind is stressed, it can wreak havoc on your body, too. Although you can’t avoid it completely, exercise has been shown to keep stress in check. Studies show that regular exercise decreases tension levels and can stabilize or even elevate your mood. Check out these ways to use exercise to control stress and anxiety. 

Helps You Get Better Sleep.

Looking for a way to get better sleep without sleep aids? Exercise could be part of the answer. A study reported on by the National Sleep Foundation identifies that people sleep better and feel more alert during the day if they get at least 150 minutes of exercise a week. If you’re lying awake at night, upping your weekly exercise might lead to longer and more restful sleep.

Improves Cardiovascular Health.

Not only does exercise help you lose weight, it also helps improve your cardiovascular fitness. Exercise has been shown to improve circulation and keep blood pressure and cholesterol levels in check, two risk factors for heart disease. Maintaining a healthy weight also helps protect you from developing diabetes or complications from uncontrolled blood sugar. 

Keeps Your Mind Sharp.

If it’s good for your heart, it’s good for your brain, too. Exercise improves brain function, and it helps protect memory and thinking skills. A study published in the journal Neurology showed that physical activity – the kind that gets your heart pumping and sweat flowing – can slow brain aging by as much as 10 years! The study also showed that people who exercised less showed a greater cognitive decline than those who exercised regularly. 

So there you have it! The next time you’re dreading a sweat session, think about all the ways ways exercise can work for you and help you live a longer, happier and healthier life.