AUGUSTA, Ga. The precision and three-dimensional view provided by robots can enable essentially scar-free surgery for some women needing hysterectomies, physicians report.
The case report in the Journal of Minimal Access Surgery is of a 46-year-old physically fit female with a history of excessive bleeding and benign growths on her uterus. Her surgery was performed through a two inch-long incision in the belly button, the thinnest part of the abdomen, using the robotic arms in a "chopstick" fashion, said Dr. John R. Lue, Chief of the Medical College of Georgia Section of General Obstetrics and Gynecology at Georgia Health Sciences University.
"This paper helps show it can be done," said Lue, corresponding author. "Now we need to do large studies to find which women would most benefit and whether it can be done for more significant pathology such as large fibroids and cancer." Cost effectiveness also needs to be assessed, he noted.
A multi-inch incision across the pubic hair line is the approach for the majority of hysterectomies in the United States. Another option one that minimizes pain, scarring and recovery time is laparoscopy, a decade-old approach involving multiple, smaller abdominal incisions that provide access for a two-dimensional camera and surgical instruments.
Robotics, which enables three-dimensional imaging and directing surgical moves from a console, improves mobility and surgical control but typically requires multiple small incisions, Lue said. The single point of entry adds improved aesthetics to its list of benefits, he said.
"It's like an extension of your own hand being inside the patient," Lue said of the fine control and access of robotics. "You can see the anatomy much clearer. I can see each blood vessel streaming blood and where your nerves are. You can see the ureter much clearer," he said, noting injury to this connector between the kidney and bladder is a known risk of lapa
|Contact: Toni Baker|
Georgia Health Sciences University