Since the introduction of minimally invasive techniques for gynecologic surgeries such as hysterectomy, removal of fibroids and endometriosis, a growing number of women have been able to avoid the traditional surgery quot; abiertaquot and have a less invasive procedure, such as laparoscopy instead. A suitable candidates, for example, minimally invasive techniques allow much smaller incisions instead of one large incision, fewer complications, less blood loss and scarring and shorter hospital stays and recovery times. br In a standard laparoscopic procedure, we make several small incisions in the abdomen and place a small camera in one of them that projects images onto a video screen. Inserting surgical instruments through ports and, guided by images on the screen, perform the surgery. br In most cases, we can successfully perform standard laparoscopic surgery. In some, however, certain factors such as location or size of a tumor, the patient's health and whether cancerous cells have spread to other areas can rule out the standard laparoscopy. Often these cases can be treated successfully with the da Vinci robotassisted surgical system. br In robotassisted surgery promotes improving the conditions of gynecologic laparoscopic surgery in several key respects. First, unlike a single camera with a scope used in standard laparoscopy, the robotic camera is a binocular telescope. This dual advantage scope provides remarkable 3D resolution and greater depth of field in the surgical area, in some cases, this allows us to perform procedures that could not have had the visual ability to perform the quot; eye desnudoquot; View of standard laparoscopy. br Second, the robotic instruments beyond that of standard laparoscopy, in essence, that mimic the human hand and wrist and can be turned and rotated for better dexterity and precision. This move greatly expands our ability to perform the surgery as it would in an open, if not better. br An example of this radical hysterectomy is often recommended for the treatment of cancer and other gynecological diseases, in fact, hysterectomy is the second most common surgical procedure for women in the United States. A hysterectomy can often be done successfully by laparoscopy and roboticassisted technology has improved so we can see more of the nerves that run through the tissues that are operating in that he could not do with the standard scope. We are now able to save more of the nerves, and consequently, a decrease in the number of patients seem to experience bladder dysfunction or need for catheter after surgery. Moreover, because there is less pull the abdominal wall with the robotic instruments, patients may experience less pain as well. br Another example is endometrial cancer or cancer of the uterine lining. This is the most common type of gynecologic cancer, standard treatment is open surgery not only to remove the organs and diseased tissues, but also to determine how far the cancer has spread. Aided by robotic technology has allowed us to make a number of these surgeries laparoscopically with the same success rates and significantly less difficulty for the patient. The same is true of early ovarian cancers that have not spread beyond the pelvis. br In addition, robotassisted surgery is ideal for a range of noncancerous gynecologic conditions that are not fatal but can cause chronic pain, heavy bleeding, infertility and other symptoms of disability, which include endometriosis, ovarian cysts, uterine fibroids, benign growths in the uterus wall, and a uterus that is falling or sliding (known as uterine prolapse). br While roboticassisted surgery can be an excellent option in cases where standard laparoscopy is not appropriate, there are some limitations. Because it is so specific, may not be the best option if the cancer has spread to a large area. Furthermore, patients who have lung problems, respiratory illnesses or may not have general anesthesia, are not good candidates for roboticassisted surgery. Finally, robotic technology is more expensive, but it can be argued these costs can be offset by shorter hospital stays and quicker return to work. br Michael Silverman, MD, is a specialist in gynecologic oncology at the Scripps Memorial Hospital La Jolla. For more information or to make an appointment with a doctor Scripps 1800SCRIPPS call. br Scripps Memorial Hospital La Jolla, minimally invasive robotic surgery (Scripps Memorial Hospital La Jolla) Gynecology and Obstetrics (Scripps Memorial Hospital La Jolla) Minimally invasive robotic surgery br br
