Robotics in Women’s Health

At Southwest General, robotic surgery overcomes many of the limitations of traditional laparoscopy and expands a surgeon’s ability to perform complex procedures.

By: Ken McEntee
Date: 09/24/2009
Leading edge robotic surgery is one of the least invasive and most effective options for women who undergo  hysterectomies and other gynecological procedures. At Southwest General, specially trained gynecological surgeons are trained to use the da Vinci S Surgical System for operations like hysterectomies, which once required major surgery.

Robotic surgery, which was introduced to Southwest General in 2006, is an improvement over laparoscopic surgery—a minimally invasive procedure that provides an alternative to traditional surgeries that leave large scars and require prolonged recovery time, explains Kristine Zanotti, MD, board-certified OB/GYN and gynecological oncologist, who is a surgical staff member at Southwest General and University Hospital’s MacDonald Women’s Hospital and Ireland Cancer Center.  

“Robotic-assisted laparoscopy has been one of the most exciting innovations in the surgical care of the two most common gynecologic cancers affecting women—uterine and cervical,” Dr. Zanotti says.

Additionally, robotic surgery overcomes many of the limitations of traditional laparoscopy and functionally expands a surgeon’s ability to perform laparoscopic procedures of increasing complexity in patients who previously posed a challenge, either due to obesity or distorted anatomy.

The da Vinci S Surgical System requires small incisions about the size of a dime and offers patients the benefits of less scarring; less post-operative pain and discomfort; less risk of infection; less blood loss; shorter recovery; and faster return to normal activities.

“Robotic surgery lets us do more complex things in a broader range of patients,” explains Dr. Zanotti, who performs robotic surgery for such procedures as hysterectomies and treatments for endometrial and cervical cancer.

“After surgery, patients can go home the next day, where a conventional laparotomy (a traditional procedure involving an incision through the abdominal wall) would leave them in the hospital for four or five days,” she says.

“The use of pain medication is reduced to a day or two instead of a week and in the case of cancer, we can get our patients ready for post-surgical treatment like chemotherapy or radiation therapy sooner than with traditional surgery. That is a tremendous benefit.”

During robotic surgery, the surgeon operates from a console that provides a three-dimensional view of the operating field and up to 10 times the magnification of the human eye. These features make it easier for the surgeon to see vital anatomical structures. “Wristed” robotic arms provide the surgeon with a full range of motion that allows for exceptional precision, Dr. Zanotti says.

Conventional laparoscopic surgery, while considered a major medical advance, is limited by the use of a two-dimensional camera and less versatile surgical instruments. It also is difficult to maneuver the instruments in obese patients due to the thickness of their abdominal wall, she explains.

“Obesity is the main risk factor of endometrial cancer, so that applies to a large number of patients,” she says. “Robotics has opened up the ability to performminimally-invasive surgery on them.”

Although Dr. Zanotti specializes in cancer surgery, robotic surgery also is used to treat other gynecological conditions, like uterine fibroids, endometriosis and prolapse (falling) of the uterus and other pelvic floor organs.

“A procedure to correct a vaginal prolapse, for example, can’t be done using conventional laparoscopy because it requires precise dissections and a lot of suturing,” Dr. Zanotti says. “Robotics has opened the door to performing that procedure without having to do traditional surgery.”

Dr. Zanotti has been performing laparoscopic surgery since she began her career 13 years ago. She said the transition to robotics three years ago was easy.

“Patients have embraced the new technology,” she says. “When I explain to them about the reduced recovery time that lets them get back to their lives, the reduction in pain and the fact that they won’t have to have a big scar for the rest of their lives, it really isn’t a very hard sell.”

To learn more about robotic surgery at Southwest General, call Health Connection at 440-816-5050.

Email This Story To A Friend

Your Friend's Email Address:

Your Name:

Your Email Address: