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  • Robotic-Assisted Gynecologic Surgery

  • The Center for Gynecologic Cancers at the Women's Medicine Collaborative offers many surgical options for gynecologic cancer.

    Many patients may benefit from the robotic-assisted surgery, which uses state-of-the-art technology to help doctors perform more precise operations than conventional instrumentation allows.

    The DaVinci Surgical System takes the best techniques of open surgery and applies them to a robotic-assisted, minimally invasive approach. The precision and dexterity of the DaVinci robot allows surgeons to perform procedures with smaller incisions and a shorter recovery time for the patient.

    Christina A. Bandera, MD, a gynecologic oncologist, ichief of obstetrics and gynecology at Rhode Island Hospital and The Miriam Hospital as well as the director of the Center for Gynecologic Cancers at the Women’s Medicine Collaborative. She is a skilled and experienced DaVinci surgeon.  

    The former director of robotic surgery at Women & Infants Hospital, Dr. Bandera answers some of the frequently asked questions about robotic-assisted gynecologic surgery.

    What is minimally invasive surgery?
    Dr. Bandera: Minimally invasive surgery is surgery without a large incision. Expected results are shorter recovery times, less blood loss, fewer complications and reduced trauma. Vaginal surgery and laparoscopy are examples of minimally invasive surgery. The newest type of minimally invasive surgery is robot-assisted laparoscopy with the DaVinci.

    Is robotic-assisted surgery similar to laparoscopic surgery?
    Robotic-assisted surgery is a type of laparoscopy using a three-dimensional camera and instruments with a greater range of motion.

    What are the benefits of robotic-assisted surgery compared with surgery through an abdominal incision?
    Robotic surgery
    As a patient, the benefits include:
    •    shorter hospital stay
    •    less pain
    •    less risk of infection
    •    less blood loss
    •    fewer transfusions
    •    minimal scarring
    •    faster recovery
    •    quicker return to normal daily activities

    For the surgeon, some of the benefits include greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access to the surgical area.

    Where will my surgery be performed?
    The Center for Gynecologic Cancers performs robotic-assisted surgery at Rhode Island Hospital. Patients are cared for in our new Women’s Health Services Inpatient Unit.

    Is robotic-assisted surgery covered by insurance?
    Insurance that covers minimally-invasive surgery generally covers surgery with the DaVinci. The coverage depends on each patient’s plan. Patients will be pre-certified to ensure coverage.

    While using the robot, can the surgeon feel anything inside the patient?

    The system relays some force feedback sensations from the surgery site to the surgeon. This is a substitute for tactile sensation.

    Does the robot ever stop functioning during surgery?
    Reports of malfunction are rare. If a problem occurs, a procedure can be converted to a laparoscopy or traditional abdominal incision.

    What gynecologic surgical procedures are being performed with the robot?
    Gynecologic surgeons are using robotic-assisted surgery to perform a hysterectomy for bleeding or pain, hysterectomy for cancer of the uterus, cervix and ovaries, cancer staging, complex surgeries to remove endometriosis, fibroid removal to preserve fertility, fallopian tube surgery to preserve fertility, and urogynecologic procedures for prolapse and incontinence.

    How long will I stay in the hospital after my robotic-assisted surgery?
    Most patients are discharged the day after their surgery.

    How many scars will I have on my abdomen?   

    Robotic surgery usually requires three to six incisions measuring less than a half of an inch each. Some patients may qualify for single-site surgery with only a small 2-inch abdominal incision. 

    How do I take care of the incisions? Are there staples or stitches?  
    Incisions are usually closed with “invisible” stitches that dissolve over time. There is nothing that needs to be removed. Incisions will be covered with a surgical glue barrier or surgical tape. Patients can shower and wet the incisions the day after surgery, but should avoid a tub bath for a month.