Robot-Assisted Laparoscopy

The da Vinci® Surgical System provides urologic surgeons like Andrea Sorcini, MD, a 3D view of the surgical site. It also improves dexterity by allowing 360-degree rotation of surgical toolsThe Lahey Hospital & Medical Center Institute of Urology is equipped with a da Vinci® Surgical System, a computerized robotic platform that enhances the performance of robot-assisted laparoscopic surgery.

As with traditional laparoscopic surgery, the surgeon operates through tiny incisions in the patient’s abdomen. The da Vinci System serves as extensions of the surgeon’s hands, and is designed to filter and translate the surgeon’s hand movements into precise movements of instruments within the surgical site.

Surgical performance is enhanced by the elimination of some of the physical challenges posed by traditional laparoscopic surgery. The da Vinci System can improve the surgeon’s visualization of delicate tissues and nerves by providing him or her with a magnified, 3D view of the surgical site. It also increases the surgeon’s dexterity by allowing for 360-degree rotation of surgical tools.

The da Vinci System is the only surgical robotic system approved by the United States Food and Drug Administration for use in performing radical prostatectomy, as well as a range of other procedures.

Meet the Robotic Surgery Team

David Canes, MDDavid Canes, MD, is the medical director of the Lahey Institute of Urology at Parkland Medical Center. He is fellowship-trained in advanced laparoscopic and robotic urology, and has been involved in more than 350 robotic urologic procedures using the da Vinci® Surgical System. Dr. Canes has helped other surgeons learn the technique of robotic prostatectomy both regionally and abroad.

Dr. Canes attended medical school at the Weill Medical College of Cornell University and went on to complete a six-year Urology residency training program at Lahey Hospital & Medical Center. Following residency, Dr. Canes pursued additional subspecialty fellowship training at the Glickman Urological and Kidney Institute of Cleveland Clinic, a world-renowned center for minimally invasive surgery. Under the mentorship of Mihir Desai, MD, and Inderbir Gill, MD, MCh, he specialized in advanced laparoscopy, robotic surgery and endourology. Subsequently, Dr. Canes was recruited to join the staff at the Institute of Urology at Lahey Hospital & Medical Center.

Dr. Canes practices at the Institute of Urology at Lahey Hospital & Medical Center in Burlington, Massachusetts, and the newly established Lahey Institute of Urology at Parkland Medical Center in Derry, New Hampshire. He primarily focuses on minimally invasive and robotic surgery for urologic cancers, including prostate, bladder, kidney, ureteral and adrenal tumors, although his training encompassed open surgery, as well. Dr. Canes’s specialty training also includes the endourologic management of complex kidney and ureteral stones.

Dr. Canes has published extensively in the field of minimally invasive urologic surgery, and has presented his work at national and international meetings. He is a member of several professional societies including the American Urological Association and the Endourology Society.

Ali Moinzadeh, MDAli Moinzadeh, MD is the director of robotic surgery at Lahey Hospital & Medical Center. He is formally trained in the management of urologic cancers and uses the latest surgical techniques with robotic and laparoscopic surgery to minimize patient morbidity. He completed a two-year fellowship in Advanced Robotic and Laparoscopic Surgery at the prestigious Glickman Urologic and Kidney Institute, Cleveland Clinic from 2003 to 2005. As of July 2010, he has performed over 1,000 minimally invasive surgical procedures, including over 550 radical prostatectomies (~500 robotic procedures), kidney, adrenal, ureter, and bladder surgeries. He played an integral part in the development and refinement of techniques for erectile nerve preservation during prostate removal for cancer while working with the world-renowned Inderbir S. Gill at the Cleveland Clinic.

Dr. Moinzadeh received his undergraduate degree with highest distinction from the University of Michigan in Ann Arbor. He earned his medical degree from Northwestern University Medical School in Chicago in 1997. Prior to his current position at Lahey Clinic, Dr. Moinzadeh completed two years of general surgery training at Massachusetts General Hospital, followed by four years of urology residency at Lahey Hospital & Medical Center. After completion of his subspecialty fellowship, he served as chief of robotic and laparoscopic surgery at the State University of New York (SUNY) Upstate Medical Center. At SUNY, he helped establish the robotics program and built one of the busiest minimally invasive urologic cancer programs in upstate New York.

At Lahey Hospital & Medical Center, Dr. Moinzadeh performed the first robotic partial nephrectomy for kidney cancer in 2007 – the first experience in New England – as well as the first robotic radical cystectomy, for bladder cancer, and the first laparoscopic renal tumor cryoablation, for kidney cancer. In 2008, under Dr. Moinzadeh’s guidance, Lahey’s Institute of Urology acquired one of the world’s first surgical robotic simulators to aid in robotic training. Besides the treatment of urologic malignancies, he has one of the highest levels of experience in the world for the treatment of adult ureteral stricture disease using the daVinci® surgical robot. He is one of the few urologists in New England with significant experience in performing retroperitoneal kidney surgery, useful in patients with multiple prior abdominal surgeries.

Dr. Moinzadeh has extensively traveled the United States, proctoring and mentoring other surgeons interested in robotic surgical training in prostatectomy, pyeloplasty, and partial nephrectomy. He has published more than 40 peer-reviewed manuscripts and authored more than 10 book chapters focusing on minimally invasive urologic oncology. He has presented and lectured at numerous scientific meetings. He is a reviewer for several urologic journals and is on the editorial board of the Canadian Journal of Urology. In 2007, he completed the program in clinical effectiveness (epidemiology, biostatistics, and health policy) at Harvard School of Public Health. Current research endeavors include the tracking of surgical data for outcomes reporting.

Andrea Sorcini, MDAndrea Sorcini, MD, is a specialist in the fields of minimally invasive surgery and urologic oncology. He joined the Urology Institute in 2000, after completing his urology residency and transplant fellowship at Lahey Hospital & Medical Center. Today, he is actively involved in the Kidney Transplant Program, Prostate Center and Center for Minimally Invasive Urologic Surgery.

Dr. Sorcini has performed many laparoscopic and open kidney operations and transplants. Under his direction, the volume of kidney transplants at Lahey Hospital & Medical Center nearly quadrupled in the early 2000s. Today he focuses primarily on urologic oncology and laparoscopic removal of cancers of the bladder, prostate, kidney and adrenal gland.

Dr. Sorcini is a graduate of the University of Rome, La Sapienza School of Medicine in Italy, where he completed a residency in general surgery in 1993. He has published many scholarly articles in the field of urologic oncology, along with videos on clinical and technical aspects of urology that have won several awards at international conferences.

Laparoscopic Procedures Offered

Surgeons at the Center for Minimally Invasive Urologic Surgery are experienced in performing each of the following techniques through both traditional and robot-assisted laparoscopic surgery:

  • Varicocelectomy: technique to treat the dilated veins in the scrotum, which can cause infertility in the patient.
  • Adrenalectomy: removal of the adrenal gland in patients with a benign (i.e., adenoma, pheochromocytoma) or malignant (i.e., cancer, metastases) enlargement of the gland.
  • Renal Cyst Marsupialization: technique to treat problematic renal cysts.
  • Nephrectomy: kidney removal technique used in cases of non-functional kidney caused by benign diseases.
  • Nephropexy: technique to secure the kidney in its proper location in patients suffering from symptoms of an abnormal mobile kidney.
  • Live Donor Nephrectomy: technique of harvesting a kidney for transplantation that adequately maintains the health and quality of the kidney.
  • Radical Nephrectomy: removal of the whole kidney, including the Gerota’s fascia and regional lymph nodes, in a tumor-bearing kidney.
  • Partial Nephrectomy: technique used to remove a renal tumor while preserving the kidney.
  • Nephroureterectomy: removal of the kidney, ureter, and bladder cuff in cases of tumors of the renal pelvis and/or ureter.
  • Pyeloplasty: technique used to repair or reconstruct the connection between the ureter and the renal pelvis in cases of a blockage of the kidney to improve drainage of the kidney down toward the bladder; it is also sometimes an alternative approach in patients with “horseshoe kidneys” and drainage problems.
  • Ureterolithotomy: surgical approach to removing ureteral stones 2 cm and larger.
  • Ureterolysis: technique used to mobilize one or both ureters that are obstructed due to retroperitoneal fibrosis, which is usually caused by inflammatory reactions; the procedure includes repositioning of the ureters to prevent a recurrence.
  • Retroperitoneal Lymph Node Dissection (RPLND): the removal of retroperitoneal lymph nodes in patients with testicular cancer in clinical stage I or IIA/B.
  • Pelvic Lymph Node Dissection: removal of the regional lymph nodes of the prostate or bladder in patients with high risk prostate or bladder cancer.
  • Radical Prostatectomy: removal of the prostate gland and seminal vesicles in patients with prostate cancer; depending on individual circumstances, this procedure can be done with preservation of one or both of the nerves that are responsible for erectile function.
  • Radical Cystectomy with Urinary Diversion: removal of the bladder in patients with bladder cancer and the creation of a bladder replacement; this includes the construction of a continent (i.e., neobladder, rectum-sigma-pouch) or incontinent (i.e., ileal loop) urinary diversion.