Dr. Carolyn's Corner
THE FUTURE IS HERE!
If you have been diagnosed with a gynecological condition which will require surgery, you may be in luck! That is to say, you may be a candidate for a “minimally invasive procedure”. Thanks to medical research and development, many gyn surgeons are now able to offer their patients minimally invasive options rather than the traditional open incisions when it comes to the need for treatment of abnormal uterine bleeding, fibroids, endometriosis, ovarian cysts, pelvic relaxation, and even cervical and uterine cancers.
It has already been shown that minimally invasive surgery, or MIS, can lead to shorter hospital stays, less post-op pain, smaller incisions, and quicker return to work than the traditional open procedures. MIS is performed by using a surgical instrument called a laparoscope which is placed inside the abdomen through a key-hole incision. A camera and light source are attached to it to allow the surgeon to view the entire area to be operated on. Additional smaller incisions (ports) are made as needed for the surgical instruments to be used.
Most of you have heard about “robotically assisted” MIS. Although studies have not yet shown greater long-term benefits over conventional laparoscopy, most physicians who are trained to use the robot agree that it allows them to operate with greater precision and control. Because the surgeon sits at a computer console in the operating room, using the robot also lessens the physical demand on him, especially in the complex, difficult cases.
It is important to know that the robot does not replace the surgeon! Each and every one of the movements of the robot arms is controlled by the physician. Small instruments which have been placed into the abdomen by the physician and his assistants are connected to the robot arms. Under the surgeon's direction, the robot matches the doctor's hand movements at the computer control to complete the surgery. The robot can only do what the surgeon directs it to do.
Although most Gyn surgeons are interested in training to use the robot, not all hospitals have a robot in their OR, mainly due to cost. (It is a highly technical piece of equipment that is expensive not only to buy, but also to maintain.) On the other hand, almost all ORs have laparoscopy equipment, so if you need Gyn surgery, most likely you can still have it done by MIS.
For those of you who are in need of a gynecological surgery, take heart! Things are so different now, even from just a decade ago. Don't be afraid to speak with your doctor about all of your surgical options. Read educational articles from trusted sources such as Ethicon-Endosurgical and Intuitive Surgical. Many of your questions will be answered at websites such as davincisurgery.com.
The physicians at Oak Hills Women's Center have several years of experience in MIS, including the robot, and are happy to consult with you about your options.