Robotic Surgery for Gynecological Problems: Wider Range of Procedures and Better Outcomes
Abnormal bleeding and pelvic pain, the cardinal symptoms of both benign and cancerous gynecological problems, are common and burdensome causes of disruptions in a women's ability to function at work, at play and in her family life. Now a new technology provides a means to perform even highly complex surgeries through using minimally invasive technology. Compared to open abdominal surgery of any kind, which involves a six - to 12-inch incision, women who undergo minimally invasive procedures that use dime-size incisions typically experience less pain, less bleeding and scarring, fewer complications, with a shorter hospital stay and faster recovery.
Fairfield County, CT (PRWEB) June 12, 2009
Abnormal bleeding and pelvic pain, the cardinal symptoms of both benign and cancerous gynecological problems, are common and burdensome causes of disruptions in a women's ability to function at work, at play and in her family life. Cancerous conditions of the reproductive organs are usually promptly treated with surgery. Yet many women delay treatment of non-cancerous gynecologic conditions, often experiencing years of suffering, said John M. Garofalo, MD (www. garofaloobgyn. com), who has provided gynecological and obstetrical care at his office in Norwalk for more than 25 years. A recent survey1 of 1,493 women aged 31-54 undergoing treatment for pelvic pain, abnormal uterine bleeding, and fibroids found that 83% reported "complete lack of or only partial symptom resolution" and almost half reported that their "pelvic problems interfered with their ability to have and enjoy sex."
After appropriate medical testing has established a non-cancerous cause of abnormal bleeding or pelvic pain, the best approach for most patients is "medical treatment" with non-steroidal anti-inflammatory medications (NSAIDs), or hormonal preparations such as birth control pills or the progesterone containing IUD. In about 50% of cases, medical treatment will provide adequate relief of symptoms within 3 months. "When medications fail to manage the conditions within six months and childbearing has been completed, she should seriously consider surgery including the option of hysterectomy" he said. "Yet the option of surgery and hysterectomy is often avoided because of the time required to recuperate from traditional open surgery and concerns, largely unfounded, about adverse effects of surgery on sexuality and femininity."
In order to reduce the postoperative pain and length of recuperation associated with traditional open surgery, gynecologists sometimes use minimally invasive surgery, commonly known as laparoscopic surgery which produces smaller scars, less pain and a more rapid return to normal activities. Although effective for many operations, laparoscopic surgery is limited to procedures of low and moderate complexity. Now, an advanced surgical system developed by Intuitive Surgical, Inc., called the da Vinci® Surgical System (www. davincisurgery. com) , combines computer and robotic technologies to provide precise control of instruments and a 3D, high-resolution views of the operating field. The da Vinci system provides a means to perform even highly complex surgeries through using minimally invasive technology, i. e. small incisions. Norwalk Hospital began offering da Vinci® surgery for gynecological and urological procedures in August 2008. "With the da Vinci system, many more women have the option of a minimally invasive procedure that results in a better quality of life all the way around," said Dr. Garofalo, who became one of the first gynecologist in Fairfield County to be certified in the use of the da Vinci® Surgical System for gynecologic surgery.
Many excellent scientific studies have shown that when treatment of benign pelvic conditions with medications is not effective, surgery - and particularly hysterectomy - is curative of the primary symptoms. In addition to cure of pain and abnormal bleeding, a large majority of patients after surgery reported improvements in overall measures of health including depression, activity limitation, sleep disturbance, fatigue and sexual functioning.2,3,4 Leaving the ovaries is very helpful in preventing adverse effects of surgery for benign pelvic problems.
"Surgery is really curative," he said, and Da Vinci® surgery makes the cure much easier to tolerate." "Compared to open abdominal surgery of any kind, which involves a six - to 12-inch incision, women who undergo minimally invasive procedures that use dime-size incisions typically experience less pain, less bleeding and scarring, fewer complications, with a shorter hospital stay and faster recovery. If done by the traditional open abdominal incision, a hysterectomy, for example, typically requires recuperation of four to six weeks; with a da Vinci® procedure, it is seven to ten days," he said. We jokingly say that "this is not your mother's hysterectomy".
In addition to hysterectomy, Dr. Garofalo is certified to use the da Vinci® Surgical System for myomectomy (removal of fibroids for infertility), sacrocolpopexy (treatment of pelvic organ prolapse), and removal of endometriosis.
For more information, visit Dr. Garofalo's website, www. garofaloobgyn. com, or call 203-803-1098. His office is at 30 Stevens Street, Suite A in Norwalk.
For more information on the Vinci® Surgical System, www. davincisurgery. com.
A senior attending physician at Norwalk Hospital, Dr. Garofalo also serves on the hospital's Quality Improvement Committee. He received his medical degree from New York Medical College in Valhalla, and his Bachelor of Arts/Biology from New York University. He served his residency at Beth Israel Medical Center in New York City.
Dr. Garofalo is a Diplomat of the American Board of Obstetrics & Gynecology, and a member of the American Association of Gynecological Laparoscopists (AAGL).
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