Robots could make scar-free hysterectomies reality
The precision and three-dimensional view provided by robots can make possible scar-free surgery for some women needing hysterectomies, according to a new study.
"This paper helps show it can be done," said Dr. John R. Lue, Chief of the Medical College of Georgia Section of General Obstetrics and Gynecology at Georgia Health Sciences University.
"Now we need to do large studies to find which women would most benefit and whether it can be done for more significant pathology such as large fibroids and cancer."
Cost effectiveness also needs to be assessed, he noted.
Robotics, which enables three-dimensional imaging and directing surgical moves from a console, improves mobility and surgical control but typically requires multiple small incisions, Lue said. The single point of entry adds improved aesthetics to its list of benefits, he said.
"It's like an extension of your own hand being inside the patient," Lue said of the fine control and access of robotics. "You can see the anatomy much clearer. I can see each blood vessel streaming blood and where your nerves are. You can see the ureter much clearer," he said, noting injury to this connector between the kidney and bladder is a known risk of laparoscopic hysterectomy.
The downside is the robotic technique can be tough to learn: physicians essentially work in reverse since the single point of entry requires the chopstick approach that leaves the right hand doing what the left typically would. "You have to think opposite of what you normally do," said Lue, who began using robotics about five years ago on cases such as large fibroids that were difficult to remove laparoscopically.
The study has been published in the Journal of Minimal Access Surgery.