The technology of laparoscopic surgery has changed greatly over the last five years with the use of the daVinci robot. In the past, difficult surgeries for things such as endometriosis, pelvic or abdominal adhesions, or hysterectomies due to large uterine fibroids, all required an abdominal incision called a laparotomy.
These larger incisions were much more difficult to recover from, usually requiring a three-day hospital stay and six to eight-week total recovery time. There was also increased pain, adhesions, blood loss, and long-term effects to a person’s quality of life associated with the surgery.
The problem with conventional laparoscopic surgery is that the instruments are rigid and do not articulate. The visualization is two-dimensional and does not give a surgeon depth perception.
This often could make cases seem difficult or even impossible when dealing with more complex surgeries when attempting then, laparoscopically. The design of the daVinci robot has certainly revolutionized the laparoscopic surgery world.
There are three major benefits to the daVinci robot: the surgical field is magnified eight-fold which allows for increasing visualization, basically operating with a zoom lens like a digital camera.
The second is three-dimensional depth perception, which allows for better development of surgical planes and dissections.
The last, and probably most significant is that the laparoscopic instruments articulate like normal human wrists, giving the surgeon the ability to operate with unbelievable precision.
All of these features collectively give a surgeon the ability to perform more difficult cases with better precision. This device is so amazing that there are videos showing a surgeon peeling the skin off of a grape.
What does this mean for a patient seeking surgery? If you have a history of adhesions, large uterine fibroids, complex pelvic floor prolapse, or other gynecologic conditions that in the past would require major incisions, you might be able to complete these with three or four small eight-millimeter incisions instead.
My own personal experience with this instrument is that it has changed my ability to perform surgery. I have not performed an open laparotomy in the past three years due to this technology.
Taking out a uterine fibroid through an incision about the size of a centimeter is a very gratifying experience, not only for the surgeon, but more importantly, the patient.
Hysterectomies are often outpatient procedures now, and more surgeries have recovery times that are much better than they were in the past. We, at Ob/Gyn West, are very skilled at more difficult surgeries and the use of the daVinci robot.