Clinical Programs / Minimally Invasive and Robotic Surgery
Minimally Invasive and Robotic Surgery - OBGYN
At UCLA Department of Obstetrics and Gynecology, our surgeons are experts in minimally invasive surgery
| Robotic Hysterectomy |
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Dr. Jeannine Rahimian, Medical Director of the UCLA OBGYN Consultation Suite, discusses Robotic Hysterectomy.
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Minimally Invasive Procedures
Minimally invasive surgical procedures avoid open invasive surgery in favor of closed or local surgery with less trauma. These procedures can often be done vaginally or involve use of laparoscopic instruments. Laparoscopy allows observation of the surgical field through an endoscope or similar device, and is carried out through small incisions in the skin to allow access into the pelvis or abdomen. This may result in shorter hospital stays, or allow outpatient treatment.
Minimally invasive surgery should have less operative trauma for the patient than an equivalent invasive procedure. Hospitalization time is shorter and the procedure causes less pain and scarring and reduces the incidence of post-surgical complications, such adhesions. Many laparoscopic procedures are considered to be relatively painless and, at worst, associated with mild discomfort. Complications are not common (only 5% of all operations).
Robotic Operating System
At UCLA Gynecologists have the benefit of using the da Vinci™ Surgical System, which enables surgeons to perform with unmatched precision and control – using only a few small incisions. The daVinci system is a robotic operating system, approved by the U.S. Food and Drug Administration for gynecologic surgery in 2005, is one of the newest technologies available for the treatment of gynecologic problems including hysterectomy and ovarian surgery for cancer and other conditions such as pelvic organ prolapse. The daVinci system offers all the benefits of laparoscopic surgery along with increased precision and effectiveness. Patients undergoing laproscopic procedures typically experience less pain, have fewer instances of infection and recover more quickly than those undergoing open surgery.
For most patients, robotic surgery can offer numerous potential benefits over traditional approaches to vaginal, laparoscopic or open abdominal hysterectomy, particularly when performing more challenging procedures like radical hysterectomy for gynecologic cancer or sacrocolpopexy for pelvic organ prolapse. Potential benefits include:
- Significantly less pain
- Less blood loss
- Fewer complications
- Less scarring
- A shorter hospital stay
- A faster return to normal daily activities
How The Robotic System Works
The robotic system consists of two interactive mechanical arms, a camera arm, a three-dimensional (3D) image processing system and a remote control unit. The unit is located in the same operating room as the patient. As the surgeon manipulates the remote control unit, the motions of the surgeon are translated to the robotic arms. Each robotic arm consists of multiple appendages connected by joints. The "hand" of the robot holds interchangeable surgical instruments that can be moved in a manner similar to a human wrist. At all times, a second surgeon is positioned at the operating table to assist with exchanging the instruments on the robotic arms.
Robotic Hysterectomy
For patients, robotic hysterectomy can offer numerous potential benefits over traditional approaches to vaginal, laparoscopic or open abdominal hysterectomy, particularly when performing more challenging procedures like radical hysterectomy for gynecologic cancer. Potential benefits include:
- Significantly less pain
- Less blood loss
- Fewer complications
- Less scarring
- A shorter hospital stay
- A faster return to normal daily activities
Moreover, robotic hysterectomy provides the surgeon with a superior surgical tool for dissection and removal of lymph nodes during cancer operations, as compared to traditional open or minimally invasive approaches. Robotic hysterectomy also allows your surgeon better visualization of anatomy, which is especially critical when working around delicate and confined structures like the bladder. This means that surgeons have a distinct advantage when performing a complex, radical hysterectomy involving adhesions from prior pelvic surgery or non-localized cancer, or an abdominal hysterectomy.
Gynecological Procedures
At the UCLA Division of Gynecologic Oncology, we are equipped and staffed to perform a wide variety of gynecological procedures including:
- Cervical and endometrial cancers
- Lymph node dissections
- Ovarian cysts and masses
- Hysterectomies (benign or cancer)
Da Vinci Surgical System
UCLA Gynecology and Urogynecology physicians offers the latest treatment for pelvic floor prolapse -- the da Vinci Surgical System is a state-of-the-art robotic technology designed to help your surgeon perform a more precise, minimally invasive procedure.
Prolapse (or falling) of any pelvic floor organ (vagina, uterus, bladder, rectum) occurs when the connective tissues within the body cavity are weak and unable to hold the structure in its natural orientation.The weakening of connective tissues accelerates with age, after child birth, with weight gain and strenuous physical labor. Women experiencing this condition typically have problems with urinary incontinence, vaginal ulceration, sexual dysfunction or having a bowel movement.
A sacrocolpopexy is a procedure that uses a mesh to hold the vagina in the correct anatomical position. This procedure can also be done in conjunction with a hysterectomy to repair a uterine prolapse condition. Sacrocolpopexy has traditionally been performed with one of two approaches: open surgery or conventional laparoscopy. Fortunately, less invasive options are available. Some gynecologic procedures enable surgeons to access the target anatomy using a vaginal approach, which may not require an external incision. But for complex hysterectomies and other gynecologic procedures, robot-assisted surgery may be the most effective, least invasive treatment option. Through tiny, 1-2 cm incisions, surgeons using the da Vinci System can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and excellent clinical outcomes.
Physicians
- Dorigo, Oliver
- Farias-Eisner, Robin
- Johnson, Michael
- Kuo, John
- Memarzadeh, Sanaz
- Rahimian, Jeannine
- Rapkin, Andrea
- Shamonki, Mousa
- Tarnay, Christopher
- Wu, Tsung-Chieh Jackson
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