Frequently Asked Questions about Gynecologic Robotic Surgery

The term MIS can be used interchangeably with laparoscopy or endoscopic surgery. Minimally invasive surgery is performed through dime-sized (1-2 cm) incisions-also called operating ports. This is in contrast to the much larger incisions used in traditional, open surgery, which are often as large as 6-12 inches long.

The smaller incisions used in MIS typically enable shorter recovery times and result in less pain, less blood loss, fewer transfusions, fewer infections and reduced hospitalization costs. While MIS has become standard-of-care for some surgical procedures, it has not been widely adopted for procedures such as prostatectomy, mitral valve repair and complex pelvic surgery.

Robotic-assisted surgery is a type of minimally invasive surgery in which a robotic instrument is completely controlled by a skilled surgeon, who manipulates mechanical arms from a console near the patient's bed. Working from a special console in the operating room next to the patient, a surgeon operates several precision-guided arms that hold and manipulate small instruments that are inserted through keyhole-sized incisions in the patient. A small video camera, inserted through another tiny incision, provides surgeons with a magnified 3D image of the operating site. The robotic arms, with their ability to rotate 360 degrees, enable the surgeon to move surgical instruments with greater precision, flexibility and range of motion than in standard minimally invasive laparoscopy.

The U.S. Food and Drug Administration (FDA) has cleared the da Vinci® Surgical System for a wide range of procedures. It was approved for gynecologic surgery in 2005.

What types of robotic-assisted gynecologic surgery does Hoag's Gynecologic Robotic Surgery team perform?

Hoag's team offers minimally invasive treatment options for a wide range of benign and malignant gynecologic surgical procedures including:

Hysterectomy (removal of the uterus)
Myomectomy (fibroid removal)
Removal of benign or cancerous tumors
Pelvic and para aortic lymphadenectomy
Omentectomy
Removal of the ovaries
Endometriosis resection
Treatment of uterine and vaginal prolapse (sacrocolpopexy)
Treatment of gynecologic cancers

Some of the benefits experienced by surgeons using the da Vinci® Surgical System over traditional approaches are greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access.

Benefits experienced by patients may include a shorter hospital stay, less pain, less risk of infection, less blood loss, fewer transfusions, less scarring, faster recovery and a quicker return to normal daily activities. None of these benefits can be guaranteed, as surgery can be both patient- and procedure-specific.

When compared to traditional "open" surgeries, robotic-assisted surgery is minimally invasive, requiring only a few small incisions in the abdomen. Traditional open gynecologic surgery requires a large incision through the abdomen for access to the uterus and surrounding anatomy.

Because robotic-assisted surgery is less invasive, patients experience less scarring, less blood loss, shorter hospitalization, quicker recovery time, fewer complications and less pain. Additionally, robotic-assisted surgery enables surgeons to clearly see the delicate structures of the pelvis.

On the day of robotic surgery, there is approximately an hour-long preparation period prior to the surgical procedure. When surgery begins, the physician makes a few small incisions in your abdomen and puts the instruments in place. Your surgeon sits at an operating console and places his hands on the controls. With full flexibility and range of motion under the surgeon's complete control, the robotic arms precisely mimic his handling of the surgical instruments. The surgeon is able to view the gynecological site through a high-definition, three-dimensional screen. During the procedure, the surgeon and assistant will always be by your side.

All of our surgeons are trained and experienced in traditional (open) and laparoscopic surgery. If the robotic system were to fail during surgery, the surgeon would continue the operation using either laparoscopy or an open incision, which would be individualized based on the patient and the type of surgery. By way of analogy, if a pilot's automatic landing systems fail, he or she will land the plane manually and will have been trained to do so.

Speak with your physician about your options and determine whether or not you are a candidate for robotic-assisted surgery. If you need a referral to a physician who has been trained in robotic-assisted surgery, please call 949-764-1834, or learn more about Hoag's expert team of gynecologic robotic surgeons here.

For help finding a surgeon who specializes in robotic-assisted surgery or to schedule a consultation, call 949-764-1834. Or view Hoag's GYN Surgeons' profiles here.