The Beauty of Robotics in General Gynecologic Surgery

Contributed by John Adler, MD, Assistant Professor of Obstetrics & Gynecology

During the early years of gynecologic surgery, there were only abdominal (laparotomy) and vaginal hysterectomy options for female patients.

In the July edition of our Women’s Center newsletter, I explained why we choose the vaginal approach as our first line of treatment for most uncomplicated hysterectomies, but that there are limits to this approach that should be considered by patients and their surgeons.

Over the last 30 years there have been improvements in laparoscopy technologies worldwide that have been adopted by gynecologic and general surgeons. Da Vinci robotic hysterectomy is a form of operative laparoscopy that many gynecologic surgeons have chosen as their preferred method for certain patients. Why? My reason for undergoing the vigorous training in robotic surgery is that I became convinced, with the da Vinci robot, I could convert many of the most difficult abdominal surgeries for benign diseases into the vaginal removal of the abnormal body parts, thus preventing large, painful, and potentially disabling incisions. This is consistent with my reasoning for advocating a renaissance in teaching the vaginal hysterectomy to younger OB/GYN physicians as they begin their careers in women’s health care. If a surgeon is proficient in the vaginal approach, it makes robotic surgery much easier when they choose to undergo robotic training. And that reasoning has held true for myself and others as more experience is gained.

There are some issues surrounding robotic gynecologic surgery which I think are important to clarify. The GYN surgeon receives no increase in compensation for utilizing this technology and the complication rates and lengths of hospital stays are the same for all laparoscopic techniques. The decision to use robotics is purely based on the preference of the individual gynecologic surgeon and the informed choice of their patients.

UC Health Women’s Center has expanded its da Vinci robotic surgery options for women in the subspecialties of General Gynecology, GYN Oncology, Reproductive Endocrinology and Infertility, and Female Pelvic Medicine and Reconstructive Surgery. The risks and benefits of this option should be discussed with every patient who needs surgical intervention.

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