LAPAROSCOPIC / ROBOTIC BIOPSIES & DISSECTIONS
When abdominal and organ pathology is found during the diagnostic work-up of complex medical conditions, biopsy samples can give doctors crucial information in guiding therapy. Minimally invasive techniques allow collection of these samples without the discomfort, unsightly scarring and extended recovery associated with traditional “open” surgical procedures. Often the first line modality to biopsy tissue is via radiologic image guided needle biopsy. This is usually performed by a radiologist in the radiology department. However, not infrequently, these samples are inadequate, either due to small size of the sample or inaccurate targeting. Other times. the target of the needle biopsy is inaccessible due to it’s location behind or near other vital structures or organs. In these circumstances, surgeons are often called upon to obtain the needed tissue for diagnosis.
In the hands of a highly skilled surgeon, laparoscopic and robotic techniques can be used to gain access to and biopsy the tissue in question. Difficult to access anatomical structures and organs can be exposed and identified by precise and delicate dissection techniques. For biopsy of tissue or masses that are not visible due to their locations inside solid organs or surrounded by other tissues, intra-operative laparoscopic ultrasound probes can be used to image the abdominal organs and structures and enable the laparoscopic surgeon to identify the targeted tissue and guide the biopsy. In addition, large enough samples can be obtained to allow pathologist to make accurate diagnoses.
There are also situations in which other surgical specialists request the assistance of a laparoscopic and robotic surgeon to provide access to or exposure of abdominal organs or anatomic structures. Whether it’s due to extensive abdominal adhesions and scar tissue, distorted anatomy, or unfamiliar organ systems, Dr. Khosravi is often requested to work in conjunction with other surgical specialists, such as gynecologists, urologists, and vascular surgeons. Complex and precise laparoscopic and robotic dissections are sometimes required to assist surgical specialists with their procedures.
INDICATIONS FOR LAPAROSCOPIC AND ROBOTIC BIOPSIES:
A patient may have a lump, mass or tumor within the abdominal cavity, identified by radiologic studies which requires a definitive diagnosis before appropriate therapy or treatment can be recommended.
Solid Organ Diseases or Masses
A patient my have a disease process of a solid organ such as the liver or pancreas which requires tissue sampling to determine the diagnosis and guide the appropriate therapy or treatment. Solid organs can also have lumps, masses, or tumors that require biopsy or sampling. Dr. Khosravi has extensive experience in biopsy techniques of abdominal organs.
Abnormally enlarged abdominal lymph nodes identified on imaging studies usually require biopsy to determine the cause of the abnormality. Lymph nodes are usually located adjacent to important blood vessels, making biopsy difficult and potentially dangerous. Biopsy of these lymph nodes often requires delicate and precision laparoscopic and robotic dissection techniques to safely and adequately remove lymph nodes for biopsy while avoiding injury to vital blood vessels. As a member of the John Theurer Cancer Center of the Hackensack University Medical Center, Dr, Khosravi is often called upon to biopsy extremely difficult to access lymph nodes to provide medical oncologist an accurate diagnosis.
INDICATIONS FOR LAPAROSCOPIC AND ROBOTIC DISSECTIONS
Many women have extensive pelvic adhesions and scar tissue from either multiple previous surgeries or chronic diseases or both, which makes gynecologic surgeries such as hysterectomy or ovarian surgeries difficult and sometimes dangerous. Dr. Khosravi works frequently at the request of his gynecologic colleagues to assist with complex laparoscopic or robotic dissections to provide access and exposure to gynecologic organs. Dr. Khosravi also works with gynecologist to do combined procedures, such as repairing hernias during gynecologic surgeries.
Whether it is to assist with dissection of extensive abdominal adhesions and scar tissue or to perform combined procedures such as hernia repairs, Dr. Khosravi frequently works with his urologic colleagues to provide unparalleled minimally invasive surgery for urology patients.