Robert Wood Johnson University Hospital
New Brunswick • Somerset

Minimally Invasive Surgery

Minimally Invasive Surgery (also known as MIS, minimal access, laparoscopic, robotic or endoscopic surgery) is a major advance in bringing to patients the excellent results of traditional surgical procedures, while eliminating the most physically and emotionally traumatic elements: the discomfort and lengthy recovery from "open" surgery. Minimally invasive surgery means having a minimum of interference with the patient's normal physiological function. Advances in laparoscopic surgery allow surgeons access to complex patient anatomy through very small incisions instead of the large incisions associated with conventional "open" surgery. Patients experience less pain and shorter recovery times.

As a nationally distinguished academic medical center, Robert Wood Johnson University Hospital is the region's leading provider in minimally invasive options for a wide variety of conditions. From cardiac surgery, to prostate and gynecology, and colorectal and neurosurgery, the Minimally Invasive Surgery Center at Robert Wood Johnson University Hospital brings the latest technology to treating the most complex cases imaginable. The Minimally Invasive Surgery Center at Robert Wood Johnson University Hospital is staffed by the talented surgeons of Robert Wood Johnson Medical School and private surgical specialists in central New Jersey.

Our Areas of Expertise

Minimally Invasive Prostate Surgery

Robert Wood Johnson University Hospital is one of the region's most active programs for robotic prostate treatment. To date, our surgeons have performed nearly 1000 surgeries using this technique. In addition, Robert Wood Johnson is recognized as a training center for residents and local surgeons.

Minimally Invasive Interventional Cardiology

Stereotactic surgery or stereotaxy is a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinate system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS) etc. The Stereotaxis Magnetic Navigation System is particularly well suited for the diagnosis and treatment of both common and complex arrhythmias, as successful treatment requires precise catheter positioning, often in hard to reach regions of the heart, which can be more consistently achieved using computerized, magnetic navigation. Magnetic Navigation is used at Robert Wood Johnson University Hospital to treat a variety of heart conditions, including:

  • Arrhythmias
    • Ventricular Tachycardia (VT)
    • Atrial Fibrillation (AF)
    • Atrial Flutter
    • Congenital Arrhythmias
    • Supraventricular Tachycardias
  • Other Conditions
    • Coronary Artery Disease, with procedures designed to reopen blocked arteries in coronary vessels with partial or total occlusion
    • Heart Failure, with interventional procedures such as cardiac resynchronization therapy

Minimally Invasive Cardiac Surgery

Robert Wood Johnson University Hospital also offers minimally invasive mitral valve repair surgery using the state-of-the-art da Vinci surgical robot. An alternative to open surgery - the traditional way to treat mitral valve disease - this new approach enables the surgeon to operate with unparalleled precision and control through a few small incisions.

In addition, Robert Wood Johnson University Hospital now offers Transcatheter Aortic Valve Replacement (TAVR) for patients with severe aortic stenosis. This new transcatheter procedure allows the diseased native heart valve to be replaced without open-heart surgery.

Minimally Invasive Neurosurgery

Gamma Knife

Robert Wood Johnson University Hospital is the only academic center in the region to offer Gamma Knife Perfexion, a non-invasive tool designed to treat brain tumors and other consditions of the brain and upper spinal cord, without harming healthy surrounding tissue. This approach, known as radiosurgery, focuses radiation directly, and very precisely, on the targeted area of the brain without affecting surrounding healthy tissue. Following is a partial list of conditions treated using the Gamma Knife at Robert Wood Johnson:

  • Primary brain tumors
  • Metastatic brain tumors
  • Acoustic neuromas
  • Meningiomas
  • Pituitary adenomas
  • Arteriovenous malformations (AVM)
  • Functional and pain disorders such as:
    • Parkinson's disease
    • Essential tremor
    • Trigeminal neuralgia

Deep Brain Stimulation (DBS)

Deep Brain Stimulation (DBS) is an adjunctive surgical treatment that is FDA approved for movement disorders. DBS does not replace medical therapy, but frequently allows reductions in medication and related side effects. During this procedure, stimulating leads are placed into deep brain targets located within the basal ganglia. The stimulating electrodes are connected to small cables passed underneath the skin and plugged into an Internal Pulse Generator (IPG), which is also implanted underneath the skin on the upper torso. The IPG is then is programmed to send a continuous stream of small, brief pulses to the tips of the stimulating leads. DBS treatment applications include:

  • Dystonia
  • Essential Tremor (ET)
  • Parkinson's Disease (PD)

Laser Ablation

In addition, Robert Wood Johnson University Hospital offers a new laser technology that utilizes light energy to destroy tumors within the brain, primary and metastatic on the spine, as well as target the area of the brain that is responsible for causing epileptic seizures. Because these procedures are guided by MRI images, they can be more precise than conventional surgery. The procedure is minimally invasive and has been reported in medical journals to be pain free and require a shorter recovery time. Laser ablation treatment applications include:

  • Epilepsy
  • Obsessive Compulsive Disorder (OCD)
  • Tourette syndrome
  • Brain tumors
    • Astrocytoma
    • Ependymoma
    • Glioblastoma
    • Meningioma
    • Schwannoma
    • Metastatic brain tumors
  • Primary and metastatic spinal tumor

Minimally Invasive OB/GYN Surgery

When medication and non-invasive procedures are unable to relieve symptoms, surgery remains the accepted and most effective treatment for a range of gynecologic conditions. These include, but are not limited to:

  • Cervical and uterine cancer
  • Uterine fibroids
  • Endometriosis
  • Uterine prolapse
  • Menorrhagia or excessive bleeding

Minimally Invasive Surgery for Newborns Through Adolescents

The Bristol-Myers Squibb Children's Hospital at Robert Wood Johnson University Hospital offers a full range of general and specialty surgery areas. Specializing in minimally invasive techniques, our surgeons provide personal and expert care to patients ranging from newborns to adolescents. Specialized instruments are used through "keyhole" incisions for a wide range of surgical problems in both the chest and the abdomen. Examples of this technique include treatment of:

  • Gastroesophageal reflux (Nissen operation)
  • Splenectomy
  • Removal of certain tumors and/or cysts
  • Lung biopsy
  • Appendectomy and treatment of empyema.

Minimally Invasive Colo-rectal Surgery and Robotics

Minimally invasive (laparoscopic and robotic) colo-rectal surgery allows the surgeon to operate on the colon through several small "ports" and a camera (similar to gall bladder surgery). The benefits include faster recovery, reduced discomfort, and quicker return to activities of daily living. The risks are the same as open surgery. Both robotic-assisted colon surgery as well as transanal endoscopic microsurgery (TEM) are avaible to patients.

Robotic-assisted colon surgery offers improved optics, allowing surgeons to visualize complex pelvic anatomy with ease. The robot offers improved dexterity, especially in the pelvis as well as providing 3-D visualization of the structures. The robot offers patients the option of a minimally invasive procedure, meaning less pain, shorter hospital stays and a quicker recovery and return to regular activities.

TEM is an advanced transanal approach that allows both large polyps and early rectal cancers to be removed transanally without requiring major abdominal surgery. With this technique, we are able to completely resect lesions higher in the rectum that traditionally required to complete colonic resections. The TEM procedure has also been used to assist in creating flaps to cure complex fistulas in patients who have had multiple prior attempts at repair. Procedures that are appropriate for minimally invasive colo-rectal surgery include, but are not limited to the following:

  • Cancer of the colon and rectum
  • Diverticulitis
  • Inflammatory bowel disease
  • Rectal prolapse
  • Colostomy
  • Colonic inertia

Minimally Invasive Bariatric Surgery

Robert Wood Johnson University Hospital (RWJUH) now offers bariatric surgery for the treatment of obesity. Weight loss surgery is an effective way of helping you meet and maintain your weight loss goals. It is a viable treatment option for morbidly obese individuals.

Minimally Invasive Esophageal Surgery

Robert Wood Johnson University Hospital offers several tests used to assess esophageal function and to investigate acid reflux (i.e., esophgeal manometry and esophageal PH testing) as well as operative treatment using laparoscopic and other minimally invasive techniques to help minimize discomfort.

Special Services

  • Laparoscopic repair of hiatal hernia and paraesophageal hernia
  • Laparoscopic treatment of gastroesophageal reflux disease
  • Laparoscopic treatment of achalasia
  • pH probe testing
  • Esophageal manometry

Minimally-Invasive General Surgery

We offer a full range of laparoscopic abdominal surgical procedures including (but not limited to):

  • Splenectomy
  • Adrenalectomy
  • Nephrectomy
  • Colo-rectal surgeries
  • Operations for GERD
  • Incisional hernia repair

Minimally-Invasive Solid Organ Surgery Program

Full service provided for laparoscopic procedures on the spleen, adrenal gland, pancreas and donor renal transplant.

Minimally Invasive Thyroid and Parathyroid Surgery

We offer operations for benign and malignant conditions of the thyroid which can be done as an out patient. We use small incisions, local anesthesia, and sedation, when appropriate. Approximately one-half of thyroid patients and 80% of parathyroid patients are cared for as out-patients.

  • Benign and malignant thyroid tumors
  • Parathyroid disease