Minimally Invasive and Robotic Gynecologic Surgery

Quick look at minimally invasive and robotic gynecologic surgery

Minimally invasive surgery (MIS) is a way of performing a gynecological operation with as little trauma to the body as possible, by making small incisions through which a camera and instruments are inserted. Robotic surgery is a type of MIS in which the surgeon directs robotic surgical tools for extreme precision.

Benefits of minimally invasive and robotic surgery include decreased postoperative pain, reduced blood loss and faster recovery time than with traditional surgery.

Risks of MIS and robotic surgery include the same complications as with any surgery, such as infections, damage to tissue, blood loss and the possible need for a larger abdominal incision.

Minimally invasive surgery (MIS) is an alternative to an open gynecological surgical procedure, and it is designed to minimize trauma to the body. During a minimally invasive procedure the surgeon makes small, half-inch size or smaller incisions. A camera and special instruments are inserted to view and operate within the abdomen and pelvis. The two most common types of MIS for gynecologic issues are described below.

What is robotic surgery?

Robotic surgery is a form of MIS that is often used in combination with laparoscopy. This procedure uses a computer that the doctor operates to control and guide a robotic arm. A camera is inserted through a small incision to give the surgeon a 3-D image of the abdominal region and pelvic organs. The surgeon then positions the robotic arms and their operating instruments via computerized controls.

Many CU Medicine clinics use the da Vinci robotic surgical system. Our doctors who perform gynecologic robotic surgeries have had extensive and specialized training. They have performed numerous robotic surgeries, and this level of experience improves surgical outcomes.

Types of minimally invasive surgery

Laparoscopy

A laparoscopy involves a doctor making between one or more small incisions under the belly button on the abdomen. A long, fiber-optic scope called a laparoscope is then inserted to assist the doctor in seeing the abdomen and its organs.

Special operating instruments are inserted through the small incisions, allowing the surgeon to operate while causing as little trauma as possible to the patient’s body. Sometimes laparoscopy can involve only viewing and diagnosis (diagnostic laparoscopy).

Hysteroscopy

Hysteroscopy utilizes a hysteroscope to give a doctor a view inside the uterus to diagnose and treat conditions, such as uterine fibroids or polyps. A hysteroscope is a thin, lighted scope that is inserted through the vagina and cervix into the uterus. An operative hysteroscopy is when the surgeon uses operating instruments inserted through the hysteroscope to treat any abnormalities.

There are no abdominal incisions during hysteroscopy because the procedure is performed through natural openings in the body. As a result, there are no scars on the abdomen. One of the benefits of a hysteroscopy is that it leaves the uterus intact, allowing for pregnancy.

What do MIS and robotic surgery treat?

Minimally invasive and robotic surgeries may be used to treat the following gynecological conditions:

• Pelvic pain and pelvic organ prolapse
• Heavy, painful periods
• Endometriosis
• Uterine fibroids, polyps or adhesions
• Gynecologic cancers (ovarian, cervical, endometrial)
• Anatomic abnormalities such as a uterine septum.

Examples of minimally invasive surgeries include:

• Hysterectomy
• Tubal ligation (getting your “tubes tied”)
• Removal of ovarian cysts
• Removal of tubes and/or ovaries.

Benefits of minimally invasive and robotic gynecologic surgeries

The greatest benefit of minimally invasive and robotic surgeries is faster recovery time, allowing for a shorter hospital stay. Depending on the procedure, some women are able to have an outpatient surgery, which means that they can leave the hospital or physician’s office the same day.

Some procedures may require staying in the hospital for one day after minimally invasive surgery, which is still less time than with an open surgery. Due to the small incisions with minimally invasive surgery there is generally a reduction in pain, infection, scarring and risk of blood clots.

Robotic surgery gives the doctor more accuracy and flexibility during the procedure due to the use of a robotic arm. This technologically advanced method of performing a gynecological procedure increases a doctor’s ability to be precise, and allows him or her to perform intricate maneuvers in tight spaces that would otherwise not be possible by human hands.

Complications & side effects

The complications of MIS and robotic surgeries are generally the same as with any surgical procedure but occur less often. They include:

• Blood clotting
• Blood loss
• Tissue and organ damage
• Infection
• Reaction to anesthesia
• Pain