Minimally Invasive Surgery

How does laparoscopic surgery apply to gynecology?

Traditionally, surgery was done using open methods because incisions needed to be large enough for the surgeon to accomplish their goals with manual control of instruments. To access targets deep in the body, these open incisions could be quite substantial, cutting through skin, muscle, and other tissue. Healing of the affected tissue took weeks and left large scars.

An instrument called a laparoscope permits procedures to be performed with much less damage to surrounding tissue. Initially a diagnostic tool, the laparoscope has both a light source and eyepiece, through which the surgeon can see inside the body without the need for a large incision. Dr. Ramos may use a laparoscope to determine if you have conditions such as endometriosis or uterine fibroids.

Laparoscopes may also be fitted with surgical instruments Dr. Ramos uses to perform procedures such as hysterectomies, ovarian cyst removals, and tubal ligation -- a permanent form of contraception. Tissue damage and scars from laparoscopic procedures are limited, and your recovery time is much faster compared with open procedures. Often, one incision is made in your navel so the scar won’t be visible once it heals.

What is robotically-assisted surgery?

Robotic surgery extends the capability of laparoscopy. A surgeon can manipulate robotically-controlled instruments with more precision than handheld tools. Robotic probes can also move and bend in ways that conventional instruments can’t. This often results in even less impact to tissue surrounding the treatment area. Dr. Ramos uses the da Vinci® Surgical System as a robotic assistant.

How does the da Vinci system work?

The da Vinci system is a general surgery robotic device that’s ideal for performing many common gynecologic laparoscopic procedures. These include:

• Hysterectomy
• Endometriosis removal
• Fibroid removal
• Pelvic prolapse surgery

Typical procedures place several small incisions around the abdomen, through which Dr. Ramos receives a high-definition, 3-D image, allowing her to control the tiny and articulate instruments that replace conventional surgical tools operated by hand. Dr. Ramos is in control of the da Vinci system at all times, and the computer translates her hand movements into smaller, more precise motions of the robotic arm as she performs the surgery.