Robotic Technology Allows Fast-Rebound Hysterectomies

A new robotic technique for performing hysterectomies - the full removal of a woman's ovaries and uterus - produces only a few tiny scars on a woman's abdomen and allows her to leave the hospital in only one or two days. The robosurgery also involves less pain, faster recovery (one to two weeks), quicker return to normal activities, less risk of wound infection and less blood loss. A conventional hysterectomy, on the other hand, is heavily invasive, requiring a 6- to 12-inch incision and four to six weeks of recovery. The hysterectomy is the second-most common surgical procedure in America, with some 600,000 being performed annually.


One of the few sites in the United States that offer robotic hysterectomies is Rush University, in Chicago, where surgeons have acquired what is known as the daVinci Surgical System. This system is composed of an operating table, a variety of complicated instruments, and an ergonomic console in which the surgeon sits a few feet away from the operating table. After four to six tiny incisions are made in the patient’s abdomen, this physician can view the internal surgical site through a high-definition, three-dimensional camera inserted through one of the incisions.
   
The doctor inserts instruments through the other incisions using robotic “arms” that he operates using hand controls and foot pedals. According to Joseph M. Maurice, a board-certified gynecologic surgeon at Rush, robotic surgery is far more precise than the conventional kind, because the instruments on the ends of the robot’s arms can rotate a full 360 degrees, and the surgeon’s hand and foot movements are scaled down, so that a hand movement of, say, an inch will cause an instrument to move only a third of an inch.

“I have 3-D vision that you can’t duplicate with conventional surgery,” said Maurice. “I’m right up next to what I’m operating on. It brings surgery to a whole different level. This is not your mother’s hysterectomy.”
   
Take Frances Gulotta, who recently turned 60. She received a daVinci hysterectomy at Rush after being diagnosed with both breast and endometrial cancer (cancer of the lining of the uterus). Doctors removed her breast tumor, and then wanted her to begin radiation treatments. But when they discovered her uterine cancer, they were forced to deal with that first.

“With a conventional hysterectomy, Frances’ radiation for her breast cancer would [have been] delayed up to six weeks,” said Maurice. “The daVinci robotic hysterectomy allowed her breast cancer therapy to begin four to six weeks earlier.”


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