Lyndhurst OR Nurse Has Firsthand Experience With Robotic Surgery

April 14, 2021

Typically, we photograph every patient appearing in HealthU. Because this story was planned during the COVID-19 pandemic, that contact would have been too risky. Instead, our team took a creative approach and replaced photo shoots with illustrated portraits of patients.

Tara Neves, who lives in Lyndhurst, New Jersey, knows all about robotic surgery—inside and out. Tara, 34, is an operating room nurse who oversees the robotic surgery department in the ambulatory setting at Hackensack University Medical Center. When Tara needed emergency robotic surgery to remove her gallbladder in July 2018, she gained the kind of firsthand experience that has made it even easier to relate to patients.

Early Warning Signs

During Tara’s second trimester of her pregnancy, she started experiencing chest pain. “I was already having a rough pregnancy, but this felt like a heart attack,” Tara says. “I told my husband that something wasn’t right, and I needed to go to the emergency room.”

Although an ultrasound revealed that Tara had gallstones, there wasn’t much her health care team could do because she was pregnant. “Surgery wasn’t an option at the time, and being pregnant, I couldn’t take anything stronger than over-the-counter pain relievers,” she says. “I had to try and control the symptoms with a diet change.”

Five months later, Tara and her husband welcomed a baby girl, and six weeks after that, Tara’s gallbladder pain returned. “I felt like I had swallowed an entire pizza and it was just sitting in my chest. The pain was so bad that it was radiating from my chest to my upper back,” she says. This time, the pain was accompanied by jaundice, which causes yellowing of the skin and eyes.

She made a second trip to the emergency room. Her care team did another ultrasound and confirmed the cause of her pain and jaundice: A gallstone had passed out of Tara’s gallbladder and was blocking her common bile duct.

Two-step Treatment

Tara knew exactly who she wanted to take care of her: Stephen G. Pereira, M.D., FACS, director of Robotic General Surgery at Hackensack. “I work with [Dr. Pereira] on a regular basis, and I knew I wanted him to take care of me,” Tara says. “He’s one of the best.”

Dr. Pereira recommended a two-fold treatment plan and said Tara needed to receive care as soon as possible. First, she needed a minimally invasive procedure called an endoscopic retrograde cholangiopancreatography (ERCP) to correct the blockage in her bile duct. During the ERCP, a thin, flexible, lighted tube called an endoscope is inserted through the mouth and into the digestive tract. Doctors placed a stent to hold her bile duct open and removed the gallstone causing the blockage.

The second step was the surgical removal of her gallbladder using the da Vinci robotic surgical system. This system includes four robotic arms: Three arms hold small surgical instruments, and one arm holds a high-definition camera. The instruments and camera are inserted into the body through several small incisions. The camera transmits a real-time, 3D video image of the surgical area to a screen on the surgical console, which contains specialized controls the surgeon uses to guide the robotic arms.

“Tara specifically asked that I perform her surgery with the robot because she understands the benefits and safety when compared to traditional surgery, including smaller incisions, faster recovery, less scarring, reduced pain and fewer complications,” Dr. Pereira says. “For surgeons and their patients, robotic surgery also provides a number of benefits over traditional laparoscopic surgery, such as 3D visibility and articulated instruments for improved precision.”

The day after Tara’s first procedure, Dr. Pereira performed a robotic cholecystectomy to remove her gallbladder. Just before surgery, Tara received an injection of a fluorescent dye called ICG, which traveled through her body and highlighted her biliary anatomy, allowing Dr. Pereira to identify her bile ducts during surgery using near-infrared imaging technology called Firefly. Firefly is incorporated into the da Vinci system.

“During robotic gallbladder surgery, there is a small risk of injury to the bile ducts, which can cause complications,” Dr. Pereira says. “Firefly allows me to clearly see the bile ducts in real-time, which lowers the risk of injury.”

Due to the combination of surgical expertise and advanced technology, Tara’s surgery and recovery went smoothly. She spent one night in the hospital after surgery. When she was discharged, she didn’t need any prescription pain medication.

“I took over-the-counter pain relievers for a day or two after my surgery,” Tara says. “I was able to walk right away and was able to take care of my daughter pretty much like normal.”

Sharing Her Experience

Tara believes her speedy recovery is a testament to the benefits of robotic surgery, and Dr. Pereira was glad robotic surgery played a role in her safe recovery and quick return to work.

“I was happy that her recovery went so well and grateful that we had our talented nurse back on our robotic surgery team,” he says.

Perhaps best of all, Tara now has a new understanding of the entire experience, which she has been happy to share with her patients.

“Now, when patients ask me questions about a procedure, I can draw from my personal and professional knowledge to provide the answers they need,” she says.

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