Are technological advances in diagnostic and therapeutic techniques at the heart of minimally invasive care for women? Will tomorrow bring remote surgery, nano-surgery, incision-less surgery and more to the GYN practionner?
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…A steady march toward using ever-more “patient-friendly” procedures in gynecological care was reflected in the proceedings of the 37th Global Congress of Minimally Invasive …
The first telesurgery session compared different ways of repairing vaginal vault prolapse, a condition where the top of the vagina protrudes into the lower portion of the vagina in women who have had hysterectomies. The second telesurgery session compared different approaches for performing hysterectomies. Participants were able to provide ongoing feedback as the procedures progressed. Additionally, there was also a radical laparoscopic hysterectomy for cervical cancer that was broadcasted live from India to the conference in Las Vegas, Nevada…
Use of robotic instruments helps surgeons perform minimally invasive gynecologic procedures with greater precision and less fatigue. A number of studies were presented on the experience of surgeons using robotics to treat a variety of gynecological problems, including hysterectomies, myomectomies (removal of fibroids), ovarian cystectomies (removal of ovarian cysts), oophorectomies (removal of the ovaries), salpingectomies (removal of the fallopian tubes), adhesiolysis (removal of scar tissue), peritoneal biopsies (taking tissue samples), and endometrial cancer.
These sessions provided evidence that robotic-assisted operative laparoscopy is feasible and effective in multiple conditions. The technology enables more surgeons to perform endoscopic surgery because of its advantages in 3-dimensional visualization, improved dexterity, reduced tension tremor for the surgeon, and shorter learning curve. Because the surgeon manipulates the instruments remotely while watching a monitor, robotics may usher in a new era of telesurgery that will enable surgeons to treat patients who are physically removed from them by hours and miles…
Single Port Access. This novel surgical technique employs one small incision instead of the three small (”keyhole”) incisions usually employed in laparoscopic surgery. Several presentations demonstrated how standard laparoscopic procedures can be performed through a single one-inch incision in the navel, including removal of the ovaries and fallopian tubes, correction of stress urinary incontinence, hysterectomy, and treatment of various gynecological cancers. The single point of entry offers cosmetic advantages to the patient, since the small scar of the incision is hidden in the navel…
N.O.T.E.S. Taking the minimally invasive principle even further, N.O.T.E.S. (Natural Orifices Translumenal Endoscopic Surgery) procedures do not use any incisions at all. Instead, a specialized scope and flexible surgical instruments are passed through the body’s natural openings such as the mouth or vagina to access internal organs. This very new field stands to revolutionize endoscopic surgery. Experience with applying the N.O.T.E.S. techniques in gynecology was presented by French surgeons.
Outpatient Procedures. Because of minimally invasive techniques, many procedures that previously required hospitalization can now be done on an outpatient basis, including hysterectomies. Data were presented on hundreds of cases of both total and supracervical hysterectomies that were successfully completed as same-day surgeries. The doctors reported low rates of complications and high rates of patient satisfaction and concluded that outpatient hysterectomy is feasible, safe, and suitable for a large number of patients…