OR-Live.com Presents: Surgical Tutorial on Complex da Vinci(R) Hysterectomy -- Strategies for Managing Endometriosis, Prior Pelvic Surgery and Large Uteri

OR-Live.com, the University of Michigan Health System and Intuitive Surgical, Inc. will present the second in a series of surgical tutorials on Complex da Vinci (robotic) Hysterectomy on September 18, 2008 from 4:00-5:30 PM (ET). Dr. Arnold P. Advincula, Associate Professor of Obstetrics and Gynecology and Director of the Minimally Invasive Gynecologic Surgery Program and Fellowship at the University of Michigan Health System, will moderate the event to explain critical portions of the surgery and to answer e-mail questions from viewers.

One complex case will be highlighted, including advanced endometriosis with associated adnexal mass, prior pelvic surgery and an enlarged uterus. Dr. Advincula will elaborate on strategies for surgically managing complex pathology while leveraging the advantages of the da Vinci® (robotic) Surgical System. He will perform a total laparoscopic hysterectomy (TLH) using all four operative arms of the da Vinci® S(TM) HD System.

The da Vinci® Surgical System is a breakthrough robotic platform designed to transcend the limitations of both traditional open surgery and conventional laparoscopy -- expanding the surgeon's ability to perform more complex gynecologic procedures using a minimally invasive approach. The da Vinci's high-definition 3D vision system, fully wristed EndoWrist® instrumentation, Intuitive® motion and ergonomic design provide unsurpassed visualization, surgical dexterity and control. These enhanced capabilities allow gynecologists to perform more complex hysterectomies with greater reproducibility across their patient population compared to conventional laparoscopy, while preserving techniques used in traditional open surgery.

Despite the broad acceptance of laparoscopy, open surgery remains the most common approach to hysterectomy. This is due in part to the learning curve associated with conventional laparoscopy and its associated complications(1) as well as the difficulty in treating advanced pathology -- such as an enlarged uterus, pelvic adhesions or endometriosis -- via laparoscopy.(2)

According to Dr. Advincula, "da Vinci provides a means to overcome both the challenges presented by advanced pathology and the surgical limitations of conventional laparoscopy. It does this by providing surgeons with improved precision and dexterity, coupled with advanced imaging, which allows for the completion of complex, minimally invasive procedures in a fashion analogous to open surgery."

The da Vinci System enables the GYN surgeon to tackle more complex pathology using a minimally invasive approach, thereby minimizing the need to perform hysterectomy via laparotomy (open incision). "I can operate with greater precision and control, which is especially valuable with more complex pathology, such as enlarged uterine pathology , pelvic adhesions or endometriosis," Advincula said. "With da Vinci, I can discern the tissue planes more easily and perform more difficult dissections -- which enables me to offer minimally invasive surgery to more of my patients," he added.

According to Dr. Advincula, " Robotic surgery is more intuitive to learn and perform compared to traditional laparoscopy, which will allow more GYN surgeons to perform minimally invasive surgery for their patients." Moreover, he added, "after you've become comfortable with the system, operative times for the da Vinci cases are comparable to that of open procedures, and based upon recent data(3) can even be faster than conventional laparoscopy."

"While more complex cases take longer, I routinely perform a simple, benign hysterectomy in 60 minutes," said Advincula. "And with new robotic instruments being introduced specific to GYN applications, da Vinci Hysterectomy and Myomectomy [removal of uterine fibroids ] procedures are becoming even easier and quicker to perform."

For many patients, da Vinci Surgery means significantly less pain and scarring, less blood loss, reduced risk of infection, shorter hospital stays, a much quicker recovery and faster return to normal daily activities compared to conventional open surgery. According to Dr. Advincula, his patients who received a da Vinci Hysterectomy typically go home the same day or the following day, and return to their lifestyles within a matter of weeks.

The University of Michigan Health System is one of the nation's leading centers in minimally invasive gynecologic surgery. It offers one of the only training programs available in robotic-assisted gynecologic surgery. With ongoing investment in technology and procedure development in minimally invasive gynecologic surgery, the University of Michigan Health System is achieving its mission to raise surgical standards-of-care for women.

About the University of Michigan Health System

The University of Michigan Health System improves the health of patients and communities through excellence in education, patient care, community service, research and technology development -- and through leadership activities in Michigan, nationally and internationally. Our mission of patient care, education and research together enhance our contribution to society.