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Clinical opinion published in American Journal of Obstetrics & Gynecology
Date:5/1/2014

When a woman requires gynecologic surgery, she and her surgeon have several minimally invasive surgical options, including robotic surgery. In recent years, the use of robotic surgery has become more and more common. But questions have arisen about the potential overuse of robotic surgery and its advantages over traditional laparotomy for hysterectomy.

A clinical opinion by Charles Rardin, MD, a urogynecologist in the Division of Urogynecology and Reconstructive Surgery and director of the Robotic Surgery Program for Women at Women & Infants Hospital of Rhode Island, director of Minimally Invasive Surgery at Care New England, and associate professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University, entitled "The debate over robotics in benign gynecology," is published this month in the American Journal of Obstetrics & Gynecology.

"Robotic surgery certainly provides some advantages to some surgeons and has contributed to a decline in laparotomy (large incision) rates for hysterectomy," said Dr. Rardin. "But robotic surgery for benign gynecology needs to be considered as just one of several forms of minimally invasive surgery (MIS) that can be used to provide the best care to patients."

Dr. Rardin explained that specific features of the patient (ie obesity), the surgeon (ie his or her experience with laparoscopic surgery), or the case (ie the possibility of significant and technically challenging suturing, such as required for a fistula repair) may make the robotic approach preferable over laparoscopic or vaginal surgery.

"However, an institution that adopts a policy of promoting robotic surgery over other forms of minimally invasive surgery is at risk of becoming a 'robotic factory' and allowing volume and quality of vaginal or laparoscopic surgeries to dwindle," he said.

In his opinion piece, Dr. Rardin suggests that other organizations consider the approach taken at th
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Contact: Amy Blustein
ablustein@wihri.org
401-681-2822
Women & Infants Hospital
Source:Eurekalert

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