July 16, 2009
The Michael E. DeBakey VA Medical Center (MEDVAMC) recently initiated clinical use of a surgical robotic system to perform minimally invasive gynecological operations, including minimally invasive hysterectomies. Ertug Kovanci, M.D., MEDVAMC Operative Care Line gynecologist reviews a patient’s chart with Diana Maldonado, L.V.N., gynecology nurse before surgery. BY: Bobbi Gruner, PAO
HOUSTON - The Michael E. DeBakey VA Medical Center (MEDVAMC) recently initiated clinical use of a surgical robotic system to perform minimally invasive gynecological operations, including minimally invasive hysterectomies.
According to the Centers for Disease Control and Prevention (CDC), 600,000 hysterectomy procedures are performed annually and are the second most frequently performed surgical procedure for women in the United States after Cesarean section.
“Robotic surgery is the future of laparoscopy,” said Ertug Kovanci, M.D., MEDVAMC Operative Care Line gynecologist. “This cutting-edge technology allows us to perform procedures endoscopically, reducing patient recovery time with less complications and a more cosmetically-pleasing outcome compared to open surgery.”
Seated at the da Vinci® Surgical System’s master console approximately ten feet away from a patient, the surgeon moves the surgical instruments inside tiny cuts in the skin using ergonomic hand and foot controls. Each of the surgeon’s hand, wrist, or finger movements is seamlessly translated by the robotic surgical system into corresponding micro-movements to the surgical instruments, which are held steady by the system’s robotic arms. The robotic system provides so-called “intuitive motion” so that in whichever direction the surgeon twists the controls, the instruments twist in the same direction. In standard laparoscopic surgery, the movement of the instruments is reversed – or similar to doing surgery while looking into a mirror.
“The robotic system is easy to learn and we can see the area with a navigational camera in a magnified, high resolution, three-dimensional view and only need to make a few tiny, one centimeter access ports to do so,” said Kovanci.
By 2010, women Veterans will make up more than 14 percent of the total Veteran population. In addition to providing comprehensive primary and specialty care for women, VA is proactively focusing on their reproductive health issues. Reducing the risk of birth defects due to teratogenic medications is a top priority. Other important efforts include improving follow-up of abnormal mammograms, tracking the timeliness of breast cancer treatment, and developing specific clinical action strategies for women with Human Papillomavirus.
“Robotic surgery for hysterectomy procedures is not appropriate for all patients. Female anatomy differs from patient to patient,” said Kovanci. “At the Michael E. DeBakey VA Medical Center, we recommend the treatment that is most appropriate for the patient and her particular medical condition.”
In the future, the MEDVAMC plans to expand use of robotic surgery techniques into the areas of cardiac, thoracic, and oncology procedures. The MEDVAMC already uses innovative, minimally invasive techniques to treat such medical conditions as atrial fibrillation, spinal fractures due to osteoporosis, heart valve surgery, and prostate cancer surgery.
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