Prescott W. Prillaman OB/GYN Specialists of Richmond |
Traditional abdominal surgery uses a single large incision to accomplish
a goal. In obstetrics and gynecology, removing a large uterus or cancer
treatments have historically been performed with these “open” surgery methods,
as some procedures can only be accomplished with a larger incision. Modern technology
has progressed and now allows for better visualization with cameras. Laparoscopy
allows for the surgeon to use a small telescope and a camera to visualize the
abdominal cavity through a 1 centimeter or less incision. Instruments that can
better mimic the human hand have been developed, and newer methods allow many
surgeries previously requiring a prolonged recovery and more post-operative
pain to be accomplished through smaller incisions with less pain and a fraction
of the recovery time. The most experienced surgeons are usually involved with
programs that have a commitment to surgical innovation and forward thinking.
The development of laparoscopy in the 1980s led to innovations that
allow surgeons to perform minor surgeries such as diagnostic laparoscopies and
tubal ligations. The 1990s ushered in hysterectomies that were assisted with
laparoscopy. The 2000s started robotic-assisted surgery and single-site
surgeries that now allow for most gynecologic surgeries to be performed using
minimally-invasive techniques. In 2011, the first single-site robotic-assisted total
hysterectomies in the Mid-Atlantic were done in Richmond.
Most laparoscopic surgical procedures use one or more 8-12 millimeter
incisions. Some surgeons feel that this method is the best for most procedures,
but it usually requires more than one incision. The diverse instrumentation has
been developed over many years, and most outpatient abdominal and gynecologic
surgery can be accomplished with this method.
Single-site surgery elevates general laparoscopy to an approach that
only uses one 20-25 mm incision. This method usually requires a specialized
port that allows for the camera and several instruments to be inserted from the
same site. Benefits of this method include
a single surgical site and less post-operative pain, with some patients able to
return to their daily lives sooner, as well as a better cosmetic result.
Robotic surgical procedures help the surgeon to perform with greater
precision due to advances in optical magnification and a development that
enables the “robotic arm” to move with the same flexibility of the human wrist.
Three to five incisions are usually required to perform the surgeries. Visibility
using magnification is 10 times greater than regular laparoscopy. The
improvements with robotics allow the surgeon to evaluate and work on areas that
cannot be accessed with traditional surgery.
The combination of single-site surgery and robotics has provided the
opportunity to perform standard laparoscopic surgeries with better visibility
and dexterity through a 25-35 mm single incision, allowing the surgeon to have
more precise movement and less tissue trauma. This method also allows for less
post-operative pain and faster recovery.
All of the above methods require substantial education and experience to
perform.
If you are in need of surgery, it is very important that you are aware
of all available options. Most patients are not as concerned about the
surgeon’s technique as they are for the concerns of going to sleep and waking
up, worrying about what might be found during surgery, and how much the surgery
will hurt. Your doctor should explain
the risks, benefits and alternatives of the surgeries.
To get prepared for surgery, there are several online resources that can
help you better understand the methods.
Sites will discuss the particular methods and blogs can help you explore
previous patient experiences. Unfortunately, it is difficult to determine if
the information you receive on the web is accurate and reliable. Web rating
sites for physicians can also be helpful but their information can sometimes be
outdated or incorrect. Be informed. You and your physician are a team with the
same goal working toward the best outcome.
For further inquiries about minimally invasive surgery,
contact Prescott W. Prillaman, MD, of OB/GYN Specialists of Richmond at
804.673.8791, or visit their website at ob-gyn-specialists.com.
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