Infertility treatments sometimes require surgery. Minimally invasive surgery, or laparoscopy, has often been the preferred approach for reproductive surgery. Minimally invasive surgery offers advantages of quicker recovery, less blood loss, and lower risk of post-operative scar tissue formation, which could itself cause infertility. At times, the effectiveness of traditional laparoscopy is limited, or more difficult to perform due to the limited range of motion of the instruments. Some difficult reproductive surgeries have required an open surgical approach, or laparotomy, which have led to longer hospital stays, recovery times, and greater costs associated with the extended hospital stay.
The da Vinci Robotic surgery has been FDA approved for Gynecologic surgeries since 2005 and has recently become a useful adjunct for reproductive surgeons. This surgical approach combines the advantages of laparoscopy, a minimally invasive approach, with the full range of motion that a surgeon has with more traditional, open surgeries. Surgeries that may not have been accomplished with traditional laparoscopy, can now be offered with the da Vinci Robotic system.
A uterine fibroid is a common type of benign (non-cancerous) tumor that develops within the uterine wall. Uterine fibroids occur in up to one third of all women and are actually the leading reason for hysterectomy (removal of the uterus) in the United States. Uterine fibroids occur in 20-40% of all women during reproductive years.
Uterine fibroids may grow as a single tumor or as clusters. They often increase in size and frequency with age, but may also revert in size after menopause. While not all women with fibroids have symptoms, others experience excessive menstrual bleeding, pelvic pain and difficulty getting pregnant.
A common alternative to hysterectomy for fibroids is myomectomy, the surgical removal of fibroid tumors and a procedure considered standard-of-care for removing fibroids and preserving the uterus. It therefore may be recommended for women who wish to become pregnant.
Myomectomy is most often performed through a large abdominal incision. After removing each fibroid, the surgeon repairs the uterus to minimize potential bleeding, infection and scarring. Proper repair is critical to reducing the risk of uterine rupture during a future pregnancy.
Fibroid embolization is newer, non-invasive treatment available but, there are limited studies showing its long-term success.
Another approach, laparoscopic myomectomy, offers a minimally invasive alternative to open surgery but is usually not an option for women with large fibroids, multiple fibroids or with fibroids in difficult-to-reach areas.
da Vinci Myomectomy
A Less Invasive Surgical Procedure
If the doctor recommends that the patient undergo surgery to treat uterine fibroids, she may be a candidate for a uterine-preserving, minimally invasive procedure – da Vinci Myomectomy. Using the most advanced technology available, da Vinci Myomectomy enables surgeons to perform this delicate operation with unmatched precision, vision and control using only a few small incisions.
For women who want a uterine-sparing procedure, da Vinci Myomectomy offers numerous potential benefits over open abdominal surgery, including:
- Significantly less pain7
- Less blood loss and need for blood transfusions7
- Shorter hospital stay8
- Faster recovery and quicker return to normal activities7
- Less scarring7
As with any surgery, these benefits cannot be guaranteed, as surgery is patient-and procedure-specific.
The Enabling Technology
The da Vinci Surgical System is designed to provide surgeons with enhanced capabilities, including high-definition 3D vision and a magnified view. The doctor controls the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside the body. Though it is often called a “robot,” da Vinci cannot act on its own; the surgery is performed entirely by the doctor.
Together, da Vinci technology allows the doctor to perform complex procedures through just a few tiny openings. As a result, the patient may be able to get back to life faster without the usual recovery following major surgery.
The da Vinci System has been used successfully worldwide in hundreds of thousands of procedures to date.
Dr. David W. Schmidt at The Center is certified in Robotic Surgery and is offering a full range of laparoscopic reproductive surgeries, including the da Vinci system.
For more information about robotic surgery and the da Vinci system please visit www.daVinciSurgery.com
To learn more about Robotic Surgery at UCHC:
- 1Myers ER, Barber MD, Gustilo-Ashby T, Couchman, Matchar DB, McCrory DC. Management of uterine leiomyomata: what do we really know? Obstet gynecol. 2002 Jul; 100(1):8-17. Review.
- 2Wallach EE, Valhos NF. Uterine myomas: an overview of development, clinical features, and management. Obstet Gynecol. 2004 Aug; 104(2):393-406. Review.
- 3Bonney V. The techniques and results of myomectomy. Lancet. 1931;220:171-177.
- 4Di Gregorio, A., Maccario, S.,Raspollini, M., Centro A.R.T.E.S. Torino, via Lamarmora 33 Turin, Italy. The role of laparoscopic myomectomy in women of reproductive age. Reproductive biomedicine online, Volume 4 Suppl 3, 2002, Pages 55-58.
- 5Hurst, B.S., Matthews, M.L.,Marshburn, P.B., Laparoscopic myomectomy for symptomatic uterine myomas. 2005 Fertility and Sterility 83(1), pp. 1-23.
- 6Senapati C, Advincula, A. Surgical techniques; robot-assisted laparoscopic myomectomy with the da Vinci® surgical system. J Robotic Surg pdf.
- 7www.brighamandwomens.org/patient/robotics/. 8Robitc gynecologic surgery. Visco, A.G., Advincula, A.P., 2008 Obstetrics and gynecology 112(6), pp. 1369-