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Robotic surgery has become a standardized procedure by urologists for prostate surgery (see my other blog showing this procedure). Over the past decade, urologists have made great strides in implementing robotic surgery for pelvic procedures. For example, in 2007, approximately 50,000 radical prostatectomies were performed with the da Vinci ® robot system in the USA, or approximately 60% of radical prostatectomies. In general, the reported results of robotic prostatectomy demonstrated less blood loss and shorter length of stay and, although the potency and continence rates were comparable, a trend was noted toward a faster return of functional outcomes.
It is an emerging technology used by gynecologists for hysterectomies and by colorectal surgeons for rectal cancers. The gynecological community has also started to utilize the robotic technology in selected patients and have shown similar results to those described by urologists for prostatectomy. That is, compared to open or laparoscopic techniques, robotic surgery for radical hysterectomy resulted in lower blood loss, less postoperative complications and shorter length of stay. The indications are still limited and patient selection is important.
This video takes you right into the operating room and shows the procedure performed by Dr M.Patrick Lowe, at Northwestern Medical Center in Chicago. There are no discussions about the indications and outcomes of this surgery. This is something the patient would need to discuss carefully with their gynecologist. Remember, in this particular operation, experience and judgment are critical!
For those who are interested in references from the medical literature, here are two:
Ko EM, Muto MG, Berkowitz RS, et al. Robotic versus open radical hysterectomy: a comparative study at a single institution. Gynecol Oncol 2008;111:425-430.
Boggess JF, Gehrig PA, Cantrell L, et al. A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol 2008;199:360