I still remember the first time I ever saw a minimally invasive robotic surgery as an Ob/Gyn resident. The patient was a young woman suffering from large tumors in her uterus, called fibroids, which caused pain, heavy bleeding, and made it difficult for her to conceive. We were doing a surgery called a Myomectomy (a surgical procedure to remove uterine fibroids ). Traditionally, the patient is put to sleep and we make an incision on the belly, like a c-section scar. We expose the uterus, find the fibroids, and cut them out one-by-one. Once all the fibroids are removed, we sew up the muscle of the uterus to restore more normal anatomy. As simple as it may sound, this is usually a very painful surgery which involves a 3-4 day hospital stay and a 6 week recovery time. During which the patient would not be able to work or exercise the next day. She may even fall victim to the myriad of complications of traditional abdominal surgery; including wound infections, blood clots, chronic pelvic pain, bladder and bowel injuries.
Luckily however, this was not the case for my patient- my patient was undergoing a “minimally invasive” myomectomy surgery.
What is Minimal Invasive Surgery?
Minimally Invasive Surgery (MIS) replaces the use of large incisions into the abdomen with smaller incisions (or in some cases, no incisions). Allowing the surgeon to view the inside of the body with a small camera and manipulate the internal organs with small surgical tools. By taking this minimally-invasive approach, surgeons have been able to reduce the pain and blood loss associated with surgery, allowing patients to resume their normal routine 1-2 weeks instead of after more than a month as is the case with “open” surgeries.
There are two main types of minimally invasive gynecologic surgery:
Laparoscopic/Robotic Surgery
Involves the use of 1-5 small incisions on the abdomen, through which tiny cameras, lights, and surgical tools are threaded by way of an entry “port” called a trocar. In laparoscopic surgery, the surgeon views the inside of the abdomen on a video screen in the operating room while also manipulating surgical tools like graspers and scissors from outside of the abdomen. In some cases, laparoscopic surgery may involve the use of a robot, in which case the surgeon sits at a high resolution 3D video station near the patient and manipulates surgical tools that are connected to four interactive arms of the robot remotely.
Hysteroscopic Surgery
Allows the surgeon to enter the body without any incision, most commonly through the vagina. In the case of hysteroscopy, the surgeon will thread a small camera and light through the vagina and cervix to view the inside of the uterus. Depending on the surgery, the surgeon may also thread other tools through the opening in order to complete the procedure.
This particular patient underwent a “Robotic Myomectomy”. A surgery that could have easily been messy, and require a hospital stay — was now clean, elegant, more precise, and took just as much, if not less time. When the patient woke up from surgery, she wasn’t nauseous, writhing in pain. After just a few hours of observation, she was well enough to be able to go home that very same day. It was at this point that I knew minimally invasive surgery was definitely something I wanted to specialize in.
I completed a 2-year Fellowship in Minimally Invasive Gynecologic Surgery in Las Vegas, Nevada. And with advanced minimally invasive training I became adept at complex vaginal, laparoscopic, and robotic surgery. I joined my mentor’s practice, became a clinical professor, and subsequently Associate Director of the program.
With Kindbody’s mission to democratize high quality women’s health and fertility care, I am able to offer my patients the most aesthetic surgical options — no matter who they are, where they come from, or what their sexual orientation is. If you have fibroids, endometriosis, adenomyosis, uterine or tubal scarring, ovarian cysts, incontinence, pelvic organ prolapse, pelvic pain, abnormal or heavy menstrual bleeding, come see us at Kindbody to discuss your minimally invasive options.
