Gynecological Procedures

The da Vinci® surgical system can be used to treat a variety of gynecological conditions, including:

• Cervical cancer
• Uterine cancer, including endometrial cancer
• Uterine fibroids (non-cancerous tumors)
• Endometriosis (non-cancerous growth of the uterine lining)
• Uterine or vaginal prolapse
• Menorrhagia (excessive menstrual bleeding)

Hysterectomy
The most common gynecological procedure is hysterectomy (removal of the uterus). For complex hysterectomies, da Vinci computer-assisted robotic surgery may be the most effective and least invasive treatment option, compared to traditional, vaginal and other laparoscopic options.¹ With da Vinci, we're able to combine the benefits of minimally invasive surgery with the accuracy and precision of traditional open hysterectomy.

Image of Female Anatomy:

The da Vinci hysterectomy is performed through several small, 1-2 cm incisions, unlike a traditional radical hysterectomy that requires a 6- to 12-inch (approximately 15- to 30-cm) incision in the abdomen. While highly effective, traditional hysterectomies are often accompanied by significant pain and a lengthy recovery process that can last up to several months. In contrast, women who undergo the da Vinci hysterectomy may benefit from reduced trauma to the body, less pain and discomfort, less scarring, reduced blood loss, a decreased risk of infection, a shorter hospital stay, and a faster recovery and return to normal daily activities.

da Vinci Compared to Other Gynecological Surgery:

In some cases, depending on the diagnosis, hysterectomies can be performed vaginally. This approach is usually limited to benign conditions that are contained within the uterus and that do not cause the uterus to become larger in size (as fibroids or cancer often do). Even when vaginal hysterectomies are appropriate given the diagnosis, surgeons may be limited by the small working space and an inability to see the pelvic organs during the procedure.

Surgeons may also opt to perform hysterectomies laparoscopically; however, traditional laparoscopic instruments may limit the surgeon's dexterity and not provide a clear enough image of the internal structures. With the da Vinci surgical system, the unique design of the EndoWrist^® instruments enhance the natural movement of the surgeon's wrists and hands, providing an even greater range of motion than possible with open surgery. A 3-D endoscope (camera) provides images of the internal organs magnified and in full-color. The enhanced visualization of the da Vinci system is particularly critical when operating around delicate and confined structures like the bladder.

Depending on the condition and diagnosis, a hysterectomy may not be the most appropriate treatment option. Uterine-preserving procedures like sacrocolpopexy and myomectomy may be considered as alternative treatment options. Talk with your doctor about all treatment options available to you, including their risks and benefits.

Sacrocolpopexy
Sacrocolpopexy is a gynecological procedure that surgically corrects vaginal or uterine prolapse. Prolapse occurs when the connective tissue around a pelvic floor organ (vagina, uterus, bladder or rectum) weakens to the point that the organ slips out of place. In a sacrocolpopexy procedure, a surgeon uses mesh to hold the prolapsed organ in its correct anatomical position. Vaginal and uterine prolapse are more common among older women who have delivered children vaginally.

Traditionally, sacrocolpopexy has been performed as an open surgery that involves making a 6- to 12-inch incision in the abdomen to access the pelvic organs. As with open hysterectomy, this kind of sacrocolpopexy often results in significant pain and a prolonged recovery. However, with da Vinci, this same procedure can be performed through tiny, dime-size incisions, potentially resulting in less pain, scarring, blood loss and recovery time.

Myomectomy
Myomectomy is performed to remove uterine fibroids, which are non-cancerous tumors. Like sacrocolpopexy, myomectomy leaves the uterus intact, which is an important benefit to women who hope to become pregnant. A myomectomy performed as a da Vinci computer-assisted robotic surgery can result in less pain, fewer complications, less scarring, a shorter hospital stay and a faster return to normal activity. The da Vinci system allows for minimally invasive, yet remarkably precise, comprehensive reconstruction of the uterine wall, regardless of the size or location of the fibroids. The unique level of control and precision made possible by the da Vinci system can help surgeons provide the most precise and thorough reconstruction possible, which may help to prevent possible uterine rupture (tearing) during future pregnancies.

It is important to remember that treatment options depend on a variety of circumstances, including age, medical history, surgical history and diagnosis. If you think a da Vinci gynecological procedure may be right for you, talk with your doctor or contact one of our Mission-affiliated da Vinci surgeons:

Blair C. Harkness, MD
Hope - A Women's Cancer Center
828-670-8403
www.hopeawcc.com

 
Timothy J. Vanderkwaak, MD
Hope - A Women's Cancer Center
828-670-8403
www.hopeawcc.com

To learn more about da Vinci gynecological procedures, visit http://www.davincisurgery.com/.