Gynecology

Gynecology

Gynecologic surgery is recommended for women facing cervical and uterine cancer, uterine fibroids, endometriosis, pelvic prolapse and excessive bleeding (menorrhagia). Patients benefit by the use of robot-assisted minimally invasive surgery by:

  • Reduced pain
  • Reduced blood loss
  • Reduced hospital pain
  • Early return to normal activities

Robotic Myomectomy

Uterine fibroids (also known as myomas) affect thirty percent of women and are abnormal, non-cancerous growths on the inside and outside of the uterus. Many fibroids do not usually need treatment, but some may cause abnormal uterine bleeding, pressure, pain or other symptoms.

Myomectomy is a procedure in which uterine fibroids are surgically removed. Surgical treatment of uterine fibroids used to involve a radical hysterectomy; the removal of the entire uterus and ovaries. However, with recent advances in surgical treatment options, surgeons may now perform surgical removal of uterine fibroids while still preserving the functionality of the uterus.

A new method of treating fibroids is embolisation of their vasculature, which causes them to shrink. However, the minimal number of studies with regard to the long-term success of this method limits its application.

Another approach is the laparoscopic removal of fibroids, which offers the advantages of the minimally traumatic method. However, it requires optimal surgical capacity, while the resulting quality of suturing and postoperative fertility is questioned by many scientists.

Even today, most of the fibroids are performed with open surgery, due to the limitations of the conventional laparoscopic method.

Evolution of the laparoscopic approach is the use of the da Vinci robotic system, which uses the most advanced technology available to overcome the challenges of laparoscopic removal of fibroids.

Robotic myomectomy allows for surgery with unparalleled precision, motion flexibility and three-dimensional image within the body.

Robotic myomectomy is poorly traumatic because it is performed through 4 micro-incisions, each less than 10 mm in length. The application of modern technology to the skilled hands of a gynecologist allows for the removal of the fibroids through those same small incisions by breaking them into smaller pieces, a process called morcellation, maintaining the uterus even after previous cesarean section or other uterine surgery.

In women where uterine retention is desirable, robotic myomectomy offers many advantages in comparison to open surgery, such as:

  • Less postoperative pain,
  • Less blood loss and need for transfusion,
  • Shorter hospitalisation,
  • Faster recovery and return to everyday life and family,
  • Fewer complications and postoperative infections,
  • Fewer post-operative symphyses,
  • Exact and strong suturing of the uterine wall in multiple layers,
  • Optimal aesthetic result with small surgical incisions.

Robotic Hysterectomy

A hysterectomy is the surgical removal of the uterus. Hysterectomies are performed for a wide variety of reasons. A hysterectomy is major surgery, but with new technological advances, the discomfort, risk of infection and recovery time has all been decreased. Robotic Hysterectomy with the use of the da Vinci platform, offers a number of benefits compared to traditional approaches to vaginal, laparoscopic or open abdominal hysterectomy, particularly when performing more challenging operations like radical hysterectomy for gynecological cancer. Benefits include fewer complications, shorter hospital stay, decreased risk of infection, and significantly less pain.

When a malignant tumour is discovered, a team of doctors will determine whether you should proceed with surgery or not. In case they decide that this is the best option, the da Vinci platform will help reduce the risks of surgery through the laparoscopic removal of malignant gynecological tumours. Uterine (endometrial) cancer can be treated by removing the uterus and examining the remaining tissues for the spread of cancer. Cervical cancer can be treated by removing the uterus and cervix and examining the remaining tissues for the spread of cancer.

Hysterectomy is traditionally performed through large (10-12 cm) abdominal incisions. Entry into the abdomen requires cutting muscles of the abdominal wall.

Open surgery hysterectomy typically lasts from one to three hours depending on the degree of difficulty and the surgeon’s experience. The patient remains 3-5 days in the hospital after hysterectomy but takes about 4-10 weeks until she returns to her daily life.

Minimally traumatic surgery was developed to reduce postoperative morbidity and complications, as well as to ensure a faster recovery and return to everyday life.

Hysterectomy is carried out through 4 small incisions, each less than 1 cm, through which the camera and tools are inserted. The uterus is removed from the abdomen by using a special tool called morcillator, whereas in case of a potential diagnosis of malignancy, it is removed through the vagina (Laparoscopically Assisted Vaginal Hysterectomy, LAVH).

In all cases of minimally invasive hysterectomy the cosmetic effect is excellent, recovery is rapid and hospitalisation is limited to a few hours postoperatively.

Robotic surgery helps overcome the technical difficulties of laparoscopy and allows major and demanding gynecological operations to be performed with minimally traumatic surgery techniques. The patient benefits of minimally traumatic surgery to an even higher degree than conventional laparoscopy. Pain postoperatively is even smaller in robotic hysterectomy, recovery is rapid and the return to daily life is achieved in a few hours.

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