Sanford Clinic Women's Health
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Maria Bell, MD with the daVinci Surgical System. |
Robotics in Gynecological Surgery
Sanford Clinic Women's Health strives to stay on the cutting edge of technology. We are one of few clinics in the nation offering robotic surgery for gynecological surgeries. Robotic surgery has been shown to reduce recovery time and decreases the numbers of open surgeries our physicians need to perform. Mark A. Talamini, M.D. Assoc. Professor of Surgery Director, Minimally Invasive Surgery at Johns Hopkins Hospital states that:
“This (technology) vastly simplifies tasks such as suturing, tying, and complex dissection, all of which are extremely challenging for most surgeons with standard laparoscopic equipment. The promise of this approach is that it will put within reach of all surgeons complicated operations using laparoscopic technology.”
Why Robotic Assisted Surgery?
Limitations of Laparoscopic surgery:
- Loss of depth perception
- Increased hand tremor
- Decreased Range of motion
- Compromise precision
- Ergonomically uncomfortable
- Difficult to learn
Advantages of Open surgery:
- Precision
- Ergonomic
- Intuitive
Is there a way to maintain the minimally invasive approach without losing the advantages of Open surgery?
Robotic Surgery:
- Hand-eye alignment
- 3D vision
- Motion scaling
- Tremor filtration
- Ambidexterity
- Restore the feel of open surgery in a minimally invasive environment
- Improved ergonomically
How does the da Vinci Surgical System work?
- Revolutionary 3-channel vision system
- High resolution 3-D image
- Panoramic view of the surgical field
- Surgeon is immersed in operative field
- Open surgery orientation
- Surgeon controls the camera thus eliminating the “Blair Witch Project
What are the Current Gynecologic and Gynecologic Oncology Applications?
Benign | Total hysterectomy, BSO, myomectomy, ovarian cystectomy, sacral-colpopexy |
Endometrial carcinoma | Total hysterectomy, BSO, pelvic and para-aortic lymph node dissection |
Cervical carcinoma | Radical hysterectomy +/- BSO, pelvic lymphadenectomy |
Bowel surgery | Left hemicolectomy, right hemicolectomy, sigmoid colectomy, colostomy reversal |
Ovarian carcinoma | Total hysterectomy BSO, pelvic and paraortic lymph node dissection, omentectomy (with standard laparoscopy) |
Does Robotics improve patient outcomes?
Example: Radical Hysterectomy
- Increased precision
- Improved visualization
- Less post operative pain
- Decreased bladder dysfunction (Average SIC 6.4 days)
- Decrease hospital stay (Average length of stay 3.0 days)
- Decrease in time back to work (average 2 weeks)
Maria Bell, MD, Sanford Clinic Women's Health has been designated 1 of four teaching centers in the country where gynecologists from across the country come to learn about robotic surgery and observe Dr. Bell performing surgery. The other three centers are the University of North Carolina, University of Michigan, and Mayo Scottsdale. Dr. Bell is a proctor for Intuitive Surgical and travels to other medical centers around the country to help gynecologists with their first cases.
Click here to download a recent lecture given by Dr. Bell including more pictures and more technical information.
