By Russell Turk, MD

Some gynecologic surgeons have entered a new frontier in minimally invasive gynecologic surgery, thanks to the da Vinci Robot, the latest advance in futuristic technology.

To clarify, robotic surgery involves the revolutionary new concept of using a surgeon’s limbs to move as they would in an open abdominal procedure: The physician sits next to the patient and looks at a magnified, three-dimensional image of the surgical field. The surgeon’s fingers are attached to controllers, which allow his or her every movement to be translated into the actions of robotic instruments placed through ports into the patient’s abdomen.

But why would you want a robot to operate on you? Surgery using the da Vinci Robot offers several advantages over traditional laparoscopy:

• Patients experience less bleeding and pain: Using more precise techniques allows even the smallest blood vessels and other vital structures to be seen as never before. As a result, routine procedures are sometimes nearly bloodless, and patients often experience less incisional pain compared with those who undergo laparoscopy. In addition, there is less post-operative pain from these small Band-Aid sized holes than in traditional laparoscopy.
• It enhances the surgeon’s skills: The complex joints of robotic instruments give surgeons more control, making complex actions such as stitching inside a patient’s abdomen much easier and quicker. The technology even filters out unintentional movements such as tremors so there's less room for human error. The magnified view provided by the robotic console allows much better visualization of the anatomy, facilitating more precise surgery and allowing the surgeon to discover pathology not otherwise visible to the naked eye.
• It allows more women to undergo minimally invasive surgery: Complex procedures can now be more safely and easily handled laparoscopically thanks to the robot’s sophisticated equipment, whereas an open incision into a patient’s abdomen may have been required previously. For example, robot-assisted surgery can be used to treat a number of gynecologic conditions, including endometriosis, heavy bleeding and large fibroids.
• Fewer women will have to go under the knife: Until robotic surgery was introduced, laparoscopic hysterectomy (the surgical removal of a woman’s uterus) and myomectomy (the removal of fibroids), were considered state-of-the-art procedures, allowing most patients to go home from the hospital either the same day or within 24 hours, and return to routine daily activities and work in one to two weeks as opposed four to six weeks after open (abdominal) procedures. This change has allowed many women to feel more comfortable undergoing surgery without having to suffer long recoveries or the financial burden of long absences from work. While we still have procedures such as ablation for symptomatic fibroids and abnormal uterine bleeding which allow women to retain their uterus, the fast recovery and safe track record of robotics means that if they choose surgery, fewer women will need traditional open-wound surgery.

In fact, organizations such as the American Association of Gynecologic Laparoscopists have already made statements notifying physicians who are not performing routine gynecologic surgery in a minimally invasive manner to hone these skills, or refer patients to a surgeon who is well-trained.

The downside of robot-assisted surgery is that only a small percentage of physicians have gone through the rigorous training process required by most institutions to be allowed to perform the surgery. To find out more about robotic surgery and the many other minimally invasive treatment options now available to women, call Dr. Turk’s office and make an appointment for a consultation today.