Minimally invasive gynecologic surgery treats benign and malignant gynecological conditions.
Unlike traditional open surgery, in which the physician makes a long incision to access the anatomy, minimally invasive surgery uses small incisions, resulting in faster recovery and less pain for the patient.
Many gynecological procedures are performed laparoscopically. To see inside the abdomen, the surgeon inserts a small telescope into the abdomen through a small incision. Tiny surgical instruments inserted through other small incisions repair the problem.
Minimally invasive surgery may also be robotic-assisted. As a result of technological advancements in surgery, even the most complex benign and malignant gynecologic conditions can now be treated in a minimally invasive fashion.
Watch our video to hear Dr. Scott Zuccala discuss the advantages of operating with a state-of-the-art robotic surgical system.
Then, see robotic surgery in action. The one-minute video below takes you into the operating room, as Dr. Ali Ghomi performs a robotic-assisted gynecologic surgery.
Pelvic reconstructive surgery is the surgical restoration of pelvic anatomy when normal support is compromised, also referred to as pelvic prolapse.
Prolapse (or falling) of pelvic organs (vagina, uterus, bladder or rectum) occurs when the supportive structures holding the organs in their natural positions are severely weakened. The weakening of the supportive tissues may be a result of age, childbirth, and strenuous physical labor. Women with pelvic organ prolapse typically experience difficulty with urination, bowel movement, and sexual function.
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Approaches to treat pelvic prolapse:
Insertion of a surgical tape under the bladder to treat urinary incontinence
Removal of the uterus through the vagina
Urinary incontinence in women can be caused by a variety of medical conditions. One condition called vesicovaginal fistula is caused by a tear in the wall separating the vagina and bladder. The condition can have a devastating psychological impact, especially in young women. Often caused by surgical complications (more than 50% of these fistulas occur after hysterectomy), radiation treatment, or childbirth, vesicovaginal fistulas usually require surgery to repair the opening.
Endometrial ablation destroys the inner lining of the uterus using an electrode that is placed in the cervix and that emits a short burst of radiofrequency energy, no longer than 90 seconds. The entire procedure typically takes less than five minutes and is performed without any incisions. There is no need for general anesthesia and most women report little or no pain. Many return to their regular activities within a day.
During a hysterectomy, the doctor removes the uterus and cervix and, for some conditions, the fallopian tubes and ovaries.
Hysterectomy is one of the most commonly performed surgical procedures in the United States. It is estimated that each year, 600,000 hysterectomies are performed in this country. However, the majority (65-70%) are still performed using outdated techniques through large abdominal incisions.
Hysterectomies that are performed in a minimally invasive way avoid large abdominal incisions, with faster recovery and less pain.
During a laparoscopic hysterectomy, the surgeon uses specialized tools that are inserted through dime-sized incisions in the navel or abdomen. A small camera provides the surgeon with a view of the inside of the abdomen, allowing the surgeon to operate with small, laparoscopic instruments, removing tissue through the tiny incisions. As with vaginal hysterectomy, there is no large abdominal incision. This type of surgery leaves tiny abdominal scars that are about one-half inch each in length. Most patients spend one night in the hospital and resume normal activity in two to four weeks.
Surgical removal of endometriosis
More than 650,000 women undergo tubal ligation in the United States annually, permanently ending their ability to have children. But what happens if circumstances change?
Studies show that within five years of undergoing a tubal ligation, approximately six percent of women decide they want to reverse the procedure to have a baby.
In September 2011, Ali Ghomi, MD, a gynecologic surgeon at Sisters of Charity Hospital, performed the area’s first tubal reversal surgery using the da Vinci Robotic Surgical System. Using the most advanced robotic technology available, Dr. Ghomi performed the delicate fallopian tube reconstructive surgery through four tiny dime-sized incisions in the patient’s abdomen.
With the da Vinci robotic tubal reversal procedure, a delicate fallopian tube reconstructive surgery through four tiny dime-sized incisions in the abdomen, patients are able to go home the same day and begin natural conception after a 7 to 10 day recovery period.
Traditionally, tubal ligation reversal surgery is performed using a Cesarean Section-type incision, followed by a two-day hospital stay and six to eight weeks of recovery. Patients may also have to postpone conception for up to two months to allow full recovery to take place.
Cervical cerclage is usually performed on women who have suffered one or more miscarriages in the second trimester because their cervix does not remain closed throughout the pregnancy. The cervix is stitched shut at the beginning of the second trimester and reopened towards the end of the pregnancy when the greatest risk of miscarriage has passed.
Extensive surgical removal of female organs to treat cervical cancer, robotic-assisted
Surgical removal of female organs and the lymph nodes to treat early uterine and ovarian cancers
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