Minimally Invasive and Robotic Surgery

Gynecology Procedures

Today the vast majority of gynecological conditions—from endometriosis to uterine fibroids, heavy menstrual bleeding to cancer—can now be treated much more effectively through minimally invasive surgery. Ovarian surgery, tubal ligation and hysterectomies can also be done using this precise surgery technique.

Highland leads New York State by volume in use of robotics for gynecologic malignancies, and Highland was the first hospital in the region to offer virtually scarless gynecologic surgery with the use of Single-Site™ Instrumentation on one of its two daVinci® surgical robots. The Single-Site™ technique is more advanced than traditional four-incision robotic procedures, and has received FDA approval for benign conditions. Only a few programs nationwide are using single-site technology for gynecology cases.

All the resources a woman needs for treatment are available at Highland – an experienced team of gynecologic oncologists who provide surgery and oncology treatment, and care for patients throughout their cancer care; an operating room team specially trained in robotic surgery; and a dedicated women’s inpatient unit for recovery.

The Gynecologic Oncology Program at Highland Hospital has received Disease-Specific Certification for uterine and ovarian cancer from the Joint Commission, the nation’s main accrediting body in health care. This certification demonstrates Highland’s commitment to the highest standards of excellence for uterine and ovarian cancer. Certification is based on compliance with national standards, effective use of evidence-based practices and an organized approach to measure performance and improvement.

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da Vinci Hysterectomy

Until recently, surgery for most gynecologic conditions was performed using a large abdominal incision. This is because while conventional laparoscopic surgery is effective for many routine procedures, the long-handled, rigid instruments used in laparoscopy are not usually considered effective for delicate or complex operations.

Fortunately, there is a minimally invasive option for treating gynecologic conditions designed to overcome the limits of traditional open and laparoscopic surgery – da Vinci Surgery.

If your doctor recommends a hysterectomy to treat your condition, you may be a candidate for da Vinci Surgery. Using state-of-the-art technology, a da Vinci® Hysterectomy requires only a few tiny incisions, so you can get back to your life faster.

Hysterectomy Incision Comparison

   Open Hysterectomy Incision   -   da Vinci Hysterectomy Incision

The da Vinci System enables your doctor to perform a minimally invasive hysterectomy even for complex conditions — with enhanced vision, precision, dexterity and control. da Vinci Hysterectomy offers women many potential benefits over traditional surgery, including:

  • Less pain1
  • Fewer complications2
  • Less blood loss 3,4
  • Shorter hospital stay 4
  • Low risk of wound infection 5
  • Quicker recovery and return to normal activities 6

1. Ko EM, Muto MG, Berkowitz RS, Feltmate CM.Robotic versus open radical hysterectomy: a comparative study at a single institution. Gynecol Oncol. 2008 Dec;111(3):425-30. Epub 2008 Oct 16.
2. Piquion-Joseph JM, Navar A, Ghazaryan A, Papanna R, Klimek W, Laroia R. Robot-assisted gynecological surgery in a community setting. Journal of Robotic Surgery, 2009:1-4.
3. DeNardis SA, Holloway RW, Bigsby GE, Pikaart DP, Ahmad S, and Finkler NJ. Robotically assisted laparoscopic hysterectomy versus total abdominal hysterectomy and lymphadenectomy for endometrial cancer. Gynecologic Oncology 2008;111:412-417.
4. Payne, T. N. and F. R. Dauterive. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol, 2008;15(3): 286-291.
5. Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, Fowler WC. A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol. 2008 Oct;199(4):360.e1-9.
6. Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, Hunt S. Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy and robotic techniques. Gynecol Oncol. 2008 Dec;111(3):407-11. Epub 2008 Oct 1.


While clinical studies support the effectiveness of the da Vinci ® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci ® Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.


Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com

da Vinci Endometriosis Resection

da Vinci Endometriosis Resection allows your surgeon to perform a thorough removal of deeply penetrated or widespread endometrial implants – while preserving your uterus. Unlike conventional open and laparoscopic surgery, da Vinci Endometriosis Resection offers the added benefit of computer and robotic-assisted technology, with the goal of minimizing the risk of your endometriosis returning.
da Vinci Endometriosis Resection offers women many potential benefits over traditional laparoscopy, including:

  •  Low blood loss1
  •  Low conversion rate to open surgery1
  •  Low rate of complications1
  •  Short hospital stay1
  •  Small incisions for minimal scarring
Endometriosis_Incision_Comparison

   Open Endometriosis Incision  -  da Vinci Endometriosis Incision

da Vinci Hysterectomy for Endometriosis

If you have decided to have a hysterectomy – removal of the uterus - you may be a candidate for da Vinci Hysterectomy, a definitive treatment for endometriosis. Potential benefits of da Vinci Hysterectomy compared to traditional open surgery include:

  • Less blood loss2
  • Fewer complications2
  • Shorter hospital stay2
  • Small incisions for minimal scarring

Potential benefits of da Vinci Hysterectomy compared to traditional laparoscopic surgery include:

  • Less blood loss3
  • Lower conversion rate to open surgery3
  • Shorter hospital stay3

1. Nezhat C, Lewis M, Kotikela S, Veeraswamy A, Saadat L, Hajhosseini B, Nezhat C. Robotic versus standard laparoscopy for the treatment of endometriosis. Fertil Steril. 2010 Dec;94(7):2758-60. Epub 2010 May 26.
2. Landeen L, Bell M, Hubert H, Seshadri-Kreaden U, Hassebroek J. A Comparative Study of Four Surgical Approaches for Hysterectomy at a Single Institution: Outcomes and Costs of Robot-Assisted, Laparoscopic, Vaginal, and Abdominal Procedures. Pending publication June 2011, South Dakota Medical Review.
3. In this study, surgeons treated patients with benign conditions that included endometriosis resection. Payne T. N. and F. R. Dauterive. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol, 2008;15(3): 286-291.
 

While clinical studies support the effectiveness of the da Vinci ® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci ® Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com

da Vinci Surgery for Uterine or Vaginal Vault Prolapse (Sacrocolpopexy)

For many women, surgery may be the best treatment option to repair pelvic prolapse, including vaginal vault prolapse. Your doctor will perform a physical exam to determine the best way to completely repair the prolapse. Pelvic prolapse surgery is known as sacrocolpopexy.  Surgical mesh is used to hold the affected pelvic organ(s) in the correct anatomical position. This procedure can also be performed after a hysterectomy to treat uterine prolapse. It provides long-term support of the vagina.1
Prolapse surgery has traditionally been performed as open surgery. A long horizontal incision is made in the lower abdomen to access the pelvic organs, but recovery after open surgery is often lengthy. Prolapse surgery can also be performed minimally invasively – through small incisions - with laparoscopic surgery. Traditional laparoscopy may present challenges due to the long-handled, rigid instruments needed for the procedure. Fortunately, there is a minimally invasive option that overcomes the limits of traditional open and laparoscopic surgery – da Vinci Surgery.
If your doctor recommends surgery to treat pelvic prolapse, you may be a candidate for da Vinci Sacrocolpopexy. Using state-of-the-art technology, da Vinci Surgery requires only a few tiny incisions, so you can get back to your life faster. The da Vinci System enables your doctor to operate with enhanced vision, precision, dexterity and control. da Vinci’s 3D, high-definition vision system allows surgeons to see key anatomy with immense depth and clarity– critical for complex conditions.
da Vinci Sacrocolpopexy offers several potential benefits over traditional open surgery, including:

  • Less blood loss2
  • Minimal need for blood transfusions2
  • Shorter hospital stay2

Sacrocolpopexy_Incision_Comparison

Potential benefits of da Vinci Surgery compared to traditional laparoscopy include:

  • Less blood loss3
  • Much shorter operation3
  • Small incisions for minimal scarring

1. Elliott DS, Krambeck AE, Chow GK. Long-term results of robotic assisted laparoscopic sacrocolpopexy for the treatment of high grade vaginal vault prolapse. J Urol. 2006 Aug;176(2):655-9.
2. Geller EJ, Siddiqui NY, Wu JM, Visco AG. Short-Term Outcomes of Robotic Sacrocolpopexy Compared With Abdominal Sacrocolpopexy. Obstetrics & Gynecology. 2008;112:1201-6.
3. Seror J, Yates DR, Seringe E, Vaessen C, Bitker MO, Chartier-Kastler E, Rouprêt M. Prospective comparison of short-term functional outcomes obtained after pure laparoscopic and robot-assisted laparoscopic sacrocolpopexy. World J Urol. 2011 Aug 20. [Epub ahead of print]

While clinical studies support the effectiveness of the da Vinci ® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci ® Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com