When medication and noninvasive procedures are unable to relieve gynecological disorder symptoms, surgery – including minimally invasive robotic surgery – remains the accepted and most effective treatment for a wide range of gynecological conditions. These include cervical cancer and uterine cancer, uterine fibroids, endometriosis, uterine prolapse and excessive uterine bleeding.
Many conditions affecting the uterus are treated with a hysterectomy, which is the surgical removal of the uterus. A hysterectomy is often the preferred treatment for symptoms such as chronic pain and bleeding, but it is also used for treatment of life-threatening conditions, such as cancer or uncontrollable bleeding in the uterus.
Traditional open gynecologic surgery typically requires a large incision for access to the uterus and the surrounding anatomy. However, with open surgery, patients often experience more pain and a longer recovery, compared to less invasive surgery.
“Fortunately, less invasive options are available. Many women, for example, are good candidates for minimally invasive robotic gynecologic surgery,” says Anupam Garg, MD, a gynecologist and robotic surgeon at Scripps Mercy Hospital San Diego and Scripps Clinic. “Robot-assisted surgery results in less scarring, less blood loss, shorter hospital stay and quicker recovery,” Dr. Garg says.
Most robot-assisted surgeries use the state-of-the-art da Vinci surgical system, which is designed to help the surgeon perform procedures with unmatched precision and control, and only a few small incisions.
Other advantages for the surgeon include increased range of motion, improved dexterity, enhanced visualization and improved access. These attributes allow surgeons to perform more complex surgical procedures than can be accomplished by traditional laparoscopic surgery.
With traditional laparoscopic surgery, several incisions are made and thin instruments, along with a video camera attached to a telescope, are inserted through the incisions. The camera transmits an image of the internal organs onto a television monitor and the surgeon uses the image as guide. Robot-assisted surgery is a laparoscopic procedure with an added layer of technology that offers better visualization of the anatomy, which is especially critical when working around delicate and confined structures like the bladder.
Robot-assisted surgery is performed through tiny incisions of one to two centimeters that cause minimal impact to the surrounding area. Patients are often able to go home after a very short stay in the hospital, and many women report little or no significant pain after surgery. The faster recovery time allows them to get back on their feet and back to their daily activities sooner, often in a matter of days.
The following robot-assisted surgery procedures are used to treat common female pelvic conditions, including:
Robotic hysterectomy surgery removes all or part of a woman’s uterus. The fallopian tubes and ovaries are also sometimes removed. Hysterectomy may be recommended for conditions including uterine or cervical cancer, uterine fibroids, menstrual disorders or severe endometriosis.
Endometriosis is a condition where the uterine lining is present in other pelvic organs, causing painful menstruation and the formation of cysts, lesions and adhesion. Endometriosis resection removes the abnormal tissue through small incisions to relieve symptoms.
Fibroids are benign tumors that develop within the uterine wall and may cause symptoms such as excessive menstrual bleeding, pelvic pain and infertility. If they are problematic, they may be removed through robotic myomectomy surgery.
The surgical removal of one or both ovaries is a common treatment option for women with ovarian cancer, ovarian cysts or other ovarian abnormalities.
Pelvic organ prolapse occurs when the natural tissue and ligaments that hold the pelvic structure in place begin to fail. Surgery can reposition organs in the pelvic cavity.