Robotic gynecologic surgery refers to the latest innovation in minimally invasive surgical techniques. It uses a narrow, lighted scope and small instruments controlled by a robotic system to treat several conditions of the female reproductive system.
Robotic gynecologic surgery is similar to laparoscopic surgery except for the way the surgeon operates.
The advantages of robotic gynecologic surgery include:
- Smaller incision
- Low death rate
- High precision
- Less postoperative pain
- Shorter hospital stays
- Higher edge in performing highly complicated surgery
- Decreased blood loss
- Faster recovery
- Better cosmetic results
- Decreased risk of infection
- Less scarring
- Improved access
- Enhanced visualization of the reproductive organ
Disadvantages of robotic gynecologic surgery include:
- Increased risk of tissue injury
- The weakening of the sutures
- More expensive
Why is robotic gynecologic surgery performed?
Robotic gynecologic surgery is indicated in:
- Uterine cancer
- Cervical cancer
- Endometriosis (a condition in which the tissue that makes the inner lining of the uterus, the endometrium, is found at places outside the uterus)
- Tubal anastomosis (joining of any two parts of the fallopian tube)
- Transabdominal cerclage (incision in the lower abdomen near the bikini line to place a small woven synthetic band high up on the cervix to prevent it from opening)
- Benign (noncancerous) gynecological tumors
- Uterine prolapse (sagging of the uterus)
- Painful periods and heavy bleeding
- Abdominal or pelvic pain
Who shouldn’t undergo robotic gynecologic surgery?
Robotic gynecologic surgery should be avoided in:
How is a gynecologic robotic surgery performed?
A robotic system includes:
- A console at which the surgeon controls the scope and instruments using hand controls and view’s the scope’s images on a screen.
- A robotic cart with arms that holds the instruments.
- A camera that gives a 3D view of the surgical site, especially of the blood vessels
- Wristed instruments that interpret the surgeon’s hand movements into precise micromovements to perform surgery.
Robotic-assisted procedures are usually performed when the patient is under general anesthesia. Seated at the console, the surgeon controls even the complex procedure through one or more small incisions with extreme perfection. The surgeon (console surgeon) controls the robotic system for any movements because it is not programmable.
Another significant part of this type of surgery is the assistant surgeon, who stands at the operating table next to the patient and manually controls additional tasks, such as fine stitching.
Robotic surgery is useful in:
- Treating endometriosis
- Performing hysterectomy (removal of the uterus)
- Performing myomectomy (removal of uterine fibroids, sparing the uterus)
- Sacrocolpopexy (repair sagging down of pelvic organs, which involves usage of surgical mesh to keep the organs in their place)
- Oophorectomy (surgical removal of one or both the ovaries)
What are the complications of robotic gynecologic surgery?
The complications of robotic gynecologic surgery include:
- Stroke
- Heart attacks
- Blood clots in the legs
- Injury to the surrounding organs
- Heavy bleeding
- Infection
SLIDESHOW
Pelvic Pain: What's Causing Your Pelvic Pain? See SlideshowReferences
https://utswmed.org/conditions-treatments/gynecologic-robotic-surgery/#:~:text=Gynecologic%20robotic%20surgery%20is%20one,affect%20a%20woman's%20reproductive%20organs.
https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/tog.12277
https://www.hopkinsmedicine.org/gynecology_obstetrics/specialty_areas/gynecological_services/treatments_services/minimally_invasive_gynecologic_robotic_surgery/
https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/tog.12277
https://www.hopkinsmedicine.org/gynecology_obstetrics/specialty_areas/gynecological_services/treatments_services/minimally_invasive_gynecologic_robotic_surgery/
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propofol
Propofol is an intravenous anesthetic drug used for general anesthesia and sedation during surgical procedures. Common side effects of propofol include injection site burning, stinging or pain; low blood pressure (hypotension), reduced cardiac output, elevated blood pressure (hypertension), pause in breathing (apnea), lung impairment (respiratory acidosis), impaired movement, high level of emulsified fats in the blood (hyperlipidemia), and high triglyceride level in blood (hypertriglyceridemia). Abuse of propofol can cause death and other injuries.succinylcholine
Succinylcholine is a skeletal muscle relaxant used for medical procedures done under general anesthesia, including tracheal intubation, mechanical ventilation, and surgeries. Common side effects of succinylcholine include postoperative muscle pain, jaw rigidity, muscle twitch (fasciculation), respiratory depression, cessation of breathing (apnea), low or high blood pressure (hypotension or hypertension), irregular heart rhythms (cardiac arrhythmias), slow or rapid heartbeat (bradycardia or tachycardia), cardiac arrest, increase in intraocular pressure (IOP), high blood potassium levels (hyperkalemia), severe life-threatening drug reaction with excessively high temperature (malignant hyperthermia), salivary gland enlargement, excessive salivation, rash, hypersensitivity reactions, and others.