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Doctor Performs Groundbreaking Surgery

09/16/08
Keck School’s Namir Katkhouda removes a gallbladder by operating through a single entry point.
By Sara Reeve
Namir Katkhouda plans to utilize the single-port access technique for more gall bladder removals as well as appendectomies.

Photo/Jon Nalick
USC surgeon Namir Katkhouda has performed the first single-port-access laparoscopic surgery on the West Coast, removing the gallbladder of a 20-year-old female patient at LAC+USC Medical Center on Aug. 25.

The surgical technique, first performed in 2007 by doctors at Drexel University College of Medicine, is a minimally invasive surgical procedure in which the surgeon operates through a single entry point, which in this case was a small incision in the navel.

“We are exploring a new world of surgery through one hole,” said Katkhouda, a renowned expert on laparoscopic surgery and professor of surgery and chief of the Minimally Invasive Surgery Program at the Keck School of Medicine of USC. He is also director of laparoscopic surgery at USC University Hospital.

Traditional laparoscopic gallbladder removal requires three to four incisions – one in the belly button and the others made through the lower chest and abdomen, resulting in multiple scars. Multiple incisions have been the common routine because several port placements were needed to facilitate movement.

“The single port does limit surgical movement, and so the surgeon needs to be very precise,” Katkhouda said. “But as long as it is done in a safe environment with experienced doctors, I think this technique is very promising.”

The patient experienced minimal discomfort and has a barely visible scar compared to traditional surgery techniques. The entire surgery took only 45 minutes, and the patient was able to leave the hospital within two hours to recover at home.

“Compared to traditional laparoscopic techniques, single-port access surgery offers patients the possibility of a better recovery, less pain and the added benefit of reduced scarring,” he said.

Katkhouda believes that single-port access surgery is preferable compared to “natural orifice” (NOTES) procedures, in which surgeons enter through the mouth, rectum or vagina in an attempt to minimize scarring. Most of these procedures require extensive training and introduce the possibility of added complications.

“NOTES involves making holes in healthy organs and just doesn’t come naturally to surgeons,” Katkhouda said. “This new technique can be easily taught to experienced surgeons and has a lot of potential for a variety of surgeries.”

Katkhouda plans to utilize the single-port access technique for more gall bladder removals as well as appendectomies. Eventually, he would like to use the procedure to perform other surgeries, including cyst removals, anti-gastric reflux procedures and adjustable gastric band surgery.

“I’m excited to offer this procedure to additional patients,” Katkhouda said. “We’re really taking minimally invasive surgery to the next level.”