Minimally Invasive Gynecologic Surgery

By Shabnam Dadgar, MD, FMIGS

Laparoscopic techniques have revolutionized the field of surgery. It offers benefits such as decreased post-operative pain and reduced narcotic requirements, earlier return to usual activities following surgery, and fewer post-operative complications e.g., wound infection, hernia), shorter hospital stay, decreased blood loss and therefore lowering the chance of needing a transfusion, less cost, faster return to work, smaller and more cosmetically appealing incisions.

Laparoscopy is a surgical technique in which the abdominal cavity is inflated with carbon dioxide gas (CO2) and distended. A small camera, usually between 5 and 10 mm (less than inch), is inserted into a patient's abdomen for the purpose of the visualization of the pelvic and abdominal organs. Several small incisions are then made for introduction of laparoscopic instruments. Gynecological procedures such as diagnosis and treatment of endometriosis, treatment of pelvic pain, removal of fibroids (myomectomy), removal of uterus (hysterectomy), removal of tubes and ovaries (salpingoophorectomy), ovarian cyst, ectopic pregnancy, tubal sterilization and tubal disease treatment and reconstruction can be done laparascopically. Conventional laparoscopy has limitations such as two-dimensional visualization, incomplete articulation of instruments, and ergonomic limitations. Since the 1980s, surgical robots have been developed to address the limitations of conventional laparoscopy. They are typically used in laparoscopy approaches.

The goal of robot-assisted laparoscopic surgery is to help improve patient care by converting procedures that would have otherwise been performed by open abdominal surgery.