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Article Category: Highlights

How People Benefit from Remarkable Robotics at Wellstar

Published on April 22, 2021

Last updated 10:39 AM April 22, 2021

Dr. Scott Miller in a Wellstar Operating Room

Thanks to high precision instruments and tiny incisions, robotic-assisted surgeons give people a chance to have better outcomes—such as less recovery pain, fewer complications and shorter hospital stays, or for some outpatient procedures, no hospital stay at all.

World-class robotic surgery close to home

“We offer patients the best-in-class robotic surgical services, spanning from cancer and cardiothoracic procedures to highly coordinated bariatric robotic surgery—and everything in between,” said Dr. Scott Miller, a Wellstar urologist in North Fulton.

Wellstar has grown to house 14 state-of-the-art da Vinci robotic surgical systems at several of our hospitals and two outpatient surgery centers.

Because of the remarkable demand for robotics and the comprehensive offerings of the program, Wellstar recently named Dr. Miller the Director of Robotic Surgical Services. In his role, he ensures best practices are followed to deliver consistent, high-quality robotic procedures across all Wellstar locations.

Tiny instruments, big benefits

Robotic surgery allows physicians to do complex surgeries with smaller incisions, less pain and less risk of infection.

For example, the length-of-stay in the hospital for a patient who has a an open colon resection is typically around a week versus just 1 ½ to 2 ½ days for a patient who has the same procedure performed by a surgeon with the assistance of a robotic surgical system.

Less tissue manipulation limits how much the tissues are altered and how long body processes go uninterrupted, which enables patients to have quicker recoveries and get back to their lives faster.

Experience is key

Just as important as the technology is the experience of the surgeon who sits at the console. Dr. Miller asserted that to have the best outcomes, patients should look for surgeons that have a high degree of experience with performing robotic surgeries.

“Our combined volume of 4,000 robotic procedures every year is very powerful,” Dr. Miller said.

The urologist himself performed the first robotic prostatectomy — or prostate removal — in the state. In the field of urology, he currently has the longest-running career of robotic surgery in Georgia. Having performed more than 3,000 robotic procedures in his career, he says the volume of the entire Wellstar robotic surgery team should give patients confidence.

Experience benefits patients because the more the surgeons have seen, the better they can work through complications that may arise. High volume centers are the places patients want to go to because they’re going to get excellent care.

Types of surgery & locations

Robotic surgery is available to patients at Wellstar across many medical specialties, including cancer surgery, cardiothoracic surgery, bariatric surgery, urology, gynecology, gastrointestinal surgery — and everything in between. In addition to outpatient procedures available at our outpatient surgery centers, many of our hospitals also offer outpatient surgery, allowing patients to go home without being admitted to the hospital.

Currently, our surgeons perform robotic procedures at these Wellstar facilities:
  • Wellstar Cobb Medical Center
  • Wellstar Douglas Medical Center
  • Wellstar Kennestone Regional Medical Center
  • Wellstar Kennestone Outpatient Surgery Center
  • Wellstar North Fulton Medical Center
  • Wellstar Paulding Medical Center
  • Wellstar Spalding Medical Center
  • Wellstar Vinings Health Park
  • Wellstar West Georgia Medical Center

Comprehensive care

While robotic-assisted surgery makes it possible for surgeons to operate through very tiny incisions, Dr. Miller says the comprehensive level of care at Wellstar is key to providing the highest quality care for patients.

“We have STAT Clinics and multidisciplinary teams in place to ensure each patient gets the right procedure at the right time,” he said.

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Scott David Miller
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Highlights

Urology and You: A Doctor Answers Sensitive Questions

The Weekly Check-up Atlanta


Dr. Scott Miller, a Wellstar urologist and expert in robotic and laparoscopic surgery, joined Dr. Bruce Feinberg on 95.5 WSB’s The Weekly Checkup. Together, they tackled common questions about urology, prostate health, incontinence and more.

Does dark urine mean I have a medical problem?

There’s no normal color for urine, Dr. Miller explained. Most of the time, expect urine to be “fairly diluted, almost like water or very pale yellow.”

Urine color may be different in the morning after a night’s sleep without hydration. Some prescription and over-the-counter medicines, like multivitamins, can also affect urine color. Any red in urine could indicate the presence of blood. That’s a sign to call your primary care provider or urologist.

Should I be worried about bubbles in my urine?

That depends, according to Dr. Miller.

“If bubbles form simply because of the way your urine stream hits the water—causing a little turbulence—there’s no need for concern,” he said. “But if you actually feel the bubbles or air passing as you urinate, that’s different. It could indicate a bladder infection or an abnormal connection between the urinary and GI (gastrointestinal) tract.”

In that case, Dr. Miller said a doctor would likely order tests to determine the cause and recommend appropriate treatment.

Do women need urologists?

Yes. Urologists specialize in treating the kidneys and the bladder in both women and men, in addition to addressing prostate health in men.

“Anyone with a urologic issue should see a urologist,” Dr. Miller said. He noted that women are more likely than men to experience conditions like kidney stones and urinary tract infections, making specialized care essential.

Is bladder leakage inevitable with aging?

Dr. Miller noted that bladder control issues are common, but they can be an avoidable part of aging.

“Some females assume bladder control is a natural consequence of childbirth or aging,” he said. “But in reality, these are all treatable issues and sometimes very simple fixes.”

Dr. Miller said that both women and men can benefit from treatments that may include medications, lifestyle changes and minimally invasive procedures. He encourages those experiencing bladder control concerns to talk with their primary care doctor or urologist rather than assume it’s something they must live with.

What about erectile dysfunction? Is it unavoidable with aging?

Erectile dysfunction (ED) can occur at any age, Dr. Miller said. But it is more common as men get older.

“ED isn’t necessarily a direct result of aging. … For instance, testosterone levels naturally decline with age, which can contribute to ED. But that’s not necessarily the cause of the erectile function,” he said.

Underlying health conditions, such as heart disease, are sometimes related to ED and are more common as people age.

People with other diseases, such as diabetes, may also experience erectile dysfunction, he explained.

At any age, patients should see a doctor as soon as they start having erectile dysfunction, Dr. Miller said. Doctors can test and rule out other causes. Early treatment for erectile dysfunction is often more successful than when patients delay seeing a doctor.

Is vasectomy safe? Is it reversible?

Not only is vasectomy safe, but it’s also the “most effective form of permanent birth control,” Dr. Miller assured listeners. The outpatient procedure is performed in a doctor’s office, and recovery is quick.

Some men worry that a vasectomy might affect their sexual function or desire, but that’s not true, Dr. Miller added. Vasectomy doesn’t affect the testicles, where testosterone, the male hormone, is produced or the delivery of the hormone to the bloodstream.

Dr. Miller said that when patients ask if vasectomy is reversible, he cautions that while vasectomy reversal is possible, it is a complex procedure with no guarantees. The patient’s age, how much time has passed since the vasectomy and the partner’s fertility all influence the chances of achieving pregnancy.

“So, never count on it,” he said. “But there are other ways to achieve pregnancy, even in someone who has had a vasectomy, including retrieving sperm directly from the testicle” then attempting in-vitro fertilization.

If I have prostate cancer, does that mean I need surgery?

Advances in prostate cancer detection and treatment have changed considerably in how doctors treat the disease, Dr. Miller said.

“Up to 40% of all prostate cancers we diagnose are at least initially candidates for active surveillance,” he said. Of those, 40 to 50% will, over three to five years, require treatment. Even in those cases, he added doctors “have a lot of ‘runway.’”

“It’s like landing a commuter jet on a 747 runway. We don’t need to start at the very beginning of the runway to safely land before the runway runs out,” he said.

For some patients, that may eventually mean they are candidates for laparoscopic surgery to remove the prostate gland or parts of it that are cancerous.

Advances in diagnostic tools, such as MRIs, genetic testing and genomic testing, have also revolutionized the detection and treatment of prostate cancer, according to Dr. Miller. Genetic testing can help determine a person’s risk of developing prostate cancer, while genomic testing reveals the molecular makeup of tumors and helps guide treatment decisions between doctors and patients.

Can I change my diet to prevent kidney stones?

Dr. Miller recommends two dietary habits to help prevent kidney stones: drinking plenty of fluids and limiting sodium intake—not only table salt, but also foods high in sodium, including diet and snack foods. He advised that when you have a meal high in sodium, counter its effects by drinking extra water.

In general, “most of the things in your diet will have very little effect on your chance of having kidney stones,” Dr. Miller said.

Because calcium is one of the chemicals that makes up kidney stones, Dr. Miller said many people ask if they should avoid calcium to prevent kidney stones. In most cases, the answer is no. Women especially need adequate calcium in their diets to support bone health and reduce their risk of osteoporosis.

Find a urologist at Wellstar

Do you have questions or concerns about your urinary health? Wellstar’s expert urologists are ready to help. Visit wellstar.org/urology to learn more or schedule an appointment.

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Highlights

Partner with Wellstar Center for Genetics to Reduce Your Risk of Cancer

While the cancer care experts at Wellstar are dedicated to providing world-class cancer treatment, our care teams are also committed to preventing disease and helping you evaluate your risk so you can be proactive with your health.

Some patients may have an increased risk of developing cancer if they have a family history or a genetic mutation. For example, a family history of prostate cancer could be indicative of a genetic mutation that increases the family’s risk for breast cancer, and vice versa. The Wellstar Center for Genetics determines if you may develop or carry certain genetic disorders. Using a compassionate approach, Wellstar genetic counselors ensure patients have the information they need to make an educated decision about genetic testing. Our team supports you every step of the way, answering questions and often working through complicated emotions.

At Wellstar, our focus is PeopleCare—personalized healthcare tailored uniquely for you. Your care team will ask you about your family’s history of cancer, including if you have had any relatives with cancer. If you do have a family history, they will ask how old your family members were when they got diagnosed. 

If you have a family history of cancer, your doctor might recommend you start screenings such as mammograms or prostate-specific antigen tests earlier or get screened more frequently. Your care team may also suggest preventative measures like medications or lifestyle changes, and they’ll partner with you to take action against potential cancers.

Some possible signs of hereditary cancer include:

  • Unusually early age of cancer onset
  • Multiple primary cancers in a single patient—primary cancers are an original tumor that forms in the body before the cancer potentially spreads
  • Cancer in paired organs (such as in cancer in both breasts)
  • Multi-generational cancers
  • Rare tumors
  • An unusual presentation, such as male breast cancer
  • Belonging to an ethnic group known to be at high risk for hereditary cancers
  • No environmental explanation for the cancer

Your care team may evaluate your risk of hereditary cancer by looking at your BRCA genes. Mutations in the BRCA1 or BRCA2 genes are most commonly associated with breast cancer, but they are also tied to an increased risk of several other cancers, including ovarian, pancreatic and prostate cancers. A BRCA gene mutation can also make a man more likely to develop breast cancer.

“Since these genetic mutations can affect someone’s risk for several different types of cancer, it’s important that you discuss any family history of cancer with both your relatives and your Wellstar care team,” Wellstar Urologist Dr. Justin Watson said. 

These conversations can be beneficial to both you and your family members.

“Men diagnosed with prostate cancer at an early age may pass along a higher genetic risk for both prostate and breast cancer to their children,” Dr. Scott Miller, Wellstar Urology specialty lead and director of robotic surgical services, explained. “Understanding these risks empowers families to take preventive steps earlier and opens the door to targeted screening programs.”

If you are wondering if you may have a genetic predisposition to certain cancers, the Wellstar Center for Genetics has nine convenient locations, and our genetic counselors can help you learn more about your risk. Your physician can refer you for genetic testing, or you can contact the genetics team directly to make an appointment. In an initial 45-minute appointment, your genetic counselor will meet with you to review your family history and discuss testing options. Most testing can be done with a saliva sample.

Genetic testing is one way that families can work to protect and inform each other so everyone can reduce their cancer risk. “The whole family is in this together,” Kimberly King-Spohn, director of the Wellstar Center for Genetics, said. “Testing helps us manage their risk and know what they're at risk for, and it's an opportunity for prevention.”

To learn more about the Wellstar Center for Genetics or make an appointment, call (470) 793-7472.

Keep reading
Physician talking to a male patient

Highlights

Are You Ready to Take Charge of Your Prostate Health?

To live life to the fullest, men need to keep a pulse on their health stats, including their prostate numbers. Regular well checks and prostate cancer screenings with a primary care physician or urologist can identify prostate conditions—like prostate cancer—early, leading to better outcomes and higher long-term survival.

Partnering with a Wellstar doctor now means that if you are diagnosed later, you’ll have a team of prostate specialists in your court who are ready to support you faster.

For example, if you have prostate-related symptoms or an elevated prostate-specific antigen test, our Prostate Health Program offers patients access to the least invasive and most advanced testing and treatment options. Plus, patients who are diagnosed with prostate cancer will have a multidisciplinary team to provide treatment options. If needed, men can have non-invasive monitoring, minimally invasive robotic surgery or highly targeted radiation therapy at Wellstar—all of which minimize side effects compared to traditional treatments.

A better approach to prostate health

Wellstar created the Prostate Health Program to offer men a safe place to discuss sensitive health topics with less anxiety. 

One benefit of seeking care at Wellstar is that the team will minimize uncomfortable testing while giving you a best-in-class evaluation that delivers clear results. And you’ll have access to advanced genetic testing. If diagnosed with prostate cancer, patients have immediate access to a team of specialists working together to create the most personalized treatment plan.

“One great benefit of the Wellstar Prostate Program is our multidisciplinary approach to prostate care,” said Wellstar Urologist Dr. Adarsh Manjunath. “We work closely with radiation and medical oncologists to provide holistic care to our patients. The collective expertise and communication between everyone involved optimizes patient well-being.”

At the first appointment, patients meet with a urologist and a nurse navigator. Navigators help bridge the gap between office visits and medical tests. They’ll facilitate scheduling any appointments that are needed, help patients prepare and arrange any follow-up care that may be needed.

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