If you have a gynecological malignancy that requires surgery, you may be a candidate for robot-assisted surgery. This technology allows the surgeon to remove tumors and associated structures in a minimally invasive procedure without large incisions and long, painful recovery times.
Dr. Sarah Temkin heads the Gynecologycial Oncology Program at the University of Maryland Greenebaum Cancer Center, and is an expert in minimally invasive surgery for GYN cancer. Here she answers some common questions about robot-assisted GYN surgery.
Robot-assisted surgery for GYN cancer means that the surgeon is using a robotic platform, like the da Vinci Surgical System we use at UMMC, to perform a hysterectomy and lymph node dissection in a minimally invasive manner. Robot-assisted surgery for GYN cancer only requires a few small incisions in the patient's abdomen through which the instruments attached to the robotic platform can be inserted into the body. These instruments mimic the surgeon's hand and wrist movements, and are completely controlled by the surgeon at a nearby console.
Performing a hysterectomy or lymph node dissection using robotic surgery is completely safe for the patient. This surgical technology has been approved by the FDA since 2005, and since then, over 100,000 robot-assisted hysterectomies have been performed throughout the United States.
A traditional hysterectomy and lymph node dissection (the most common treatment option for patients diagnosed with GYN cancer) requires a long vertical incision from the pubic bone to just above the navel. This size of this incision can result in a lengthy recovery of approximately six weeks and an increased risk of infection for some patients. Patients are also often left with a large scar and some abdominal muscle weakness following the procedure.
Both laparoscopy and robot-assisted surgery require smaller incisions, which result in a quicker recovery for the patient and decreased risk of infection. With laparoscopy, however, it feels almost like the surgeon is using chopsticks to perform the operation. The tools used to perform laparoscopic procedures are rigid and do not allow for the extended range of mobility offered by the instruments used during robot-assisted surgery. As a result, procedures that are often challenging to perform with laparoscopy are made easier with robot-assisted surgery.
No, the surgeon is in control of the entire surgical system throughout the procedure. Although the robot allows the surgeon to make more precise hand and wrist movements, it cannot be programmed to perform surgery on its own. All maneuvers must be performed by a qualified surgeon.
There are a number of factors that will determine whether or not a patient is eligible to be treated with robot-assisted surgery, including:
Patients who have robotic surgery have been shown to have less pain after surgery, fewer complications, shorter hospital stays, and faster recovery times. The four small incisions causes only minimal scarring after healing.
Generally speaking, using robot-assisted surgery to help treat GYN cancer makes it much easier to perform complex surgical procedures because of the robot's articulating instruments. Other benefits include a higher level of surgical precision, increased range of motion, and improved access to the affected area within the patient's body.
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