Significant Benefits Seen in Robotically Assisted Laparoscopic Gynecologic Surgery

“With the robot, we can extend the opportunity for minimally invasive procedures to patients with more complex issues who previously were not candidates for conventional laparoscopy,” says David P. Warshal, MD, Director of the Gynecologic Cancer Center at the Cooper Cancer Institute. Dr. Warshal is using the da Vinci® Surgical System primarily for staging (lymph node dissection) and treating endometrial and cervical cancers (hysterectomy), and staging ovarian cancer (lymph node dissection and additional biopsies).

“The robotic approach offers patients significant advantages including fewer postoperative and intraoperative complications, less pain and a quicker return to normal activities,” he adds. The small incisions heal faster and essentially eliminate the majority of wound complications that are so frequently encountered in heavier women, particularly those with hypertension and diabetes, who undergo surgery through standard abdominal incisions.”

Karolynn T. Echols, MD, FACOG, Director of Education, Research, and Urodynamics in Cooper’s Division of Female Pelvic Medicine and Reconstructive Surgery, uses the robot chiefly for sacrocolpopexy, the gold-standard for pelvic organ prolapsed repair.

“In sacrocolpopexy, we operate in an area with huge blood vessels and a lot of nerves, and the robot provides much greater visualization,” Dr. Echols says. “Plus, the patient can go home the next day, and there are cosmetic advantages. It gives patients a good option for reconstruction besides abdominal or transvaginal surgery.”

Saifudden T. Mama, MD, MPH, FACOG, Head, section of Minimally Invasive Gynecology and Robotics in Cooper’s Department of Obstetrics & Gynecology uses the robot for a variety of procedures including hysterectomy endometriosis treatment, uterus-sparing fibroid removal and complex pediatric reconstructive surgery.

“I see a lot of adult patients with severe adhesions from multiple prior surgeries, and whose small and large bowels are stuck to the uterus, he says. “With the robot I can do extensive dissection without opening the belly – a big advantage for the patient. And the robot is so flexible, I’m able to function like two people in the OR.

“Here at Cooper, we have a cadre of specialists who not only know the robot but also are tremendously experienced surgeons,” he stresses. “So it’s not just the technology, but the person behind the robot that’s very important.

“A lot of patients are still getting open surgery when they can get something less painful with a faster recovery,” he adds. “That doesn’t make any sense. There’s no real reason not to do what’s best for the patient.”

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