Advances in Robotic Surgery Are Changing Hysterectomy

GUADALAJARA, Mexico — Robotic surgery has changed clinicians' approach to patients for whom hysterectomy is considered, said Dr Carlos Alcivia Smith at the XXXI International Congress of Gynecology and Obstetrics.

According to the gynecologist, endoscopist, and robotic surgeon, this natural evolution has changed the surgical technique to make incisions smaller and less invasive over time. In addition, the development of instruments has allowed for more "elegant" surgeries.

Some of the challenges of conventional laparoscopic surgery are the two-dimensional images, hand-eye coordination difficulty, amplification of physiological tremors, a steep learning curve, and limited articulated movements, he added.

"No matter how skilled a surgeon is, obviously tremors or fatigue take a toll on them. There are some very interesting estimates that robotic surgery extends the surgeon's career by up to 12 years," he said.

In 1998, the first robotic surgery was performed on a human being. In 2000, the first gynecologic robotic surgery (a tubal anastomosis) was carried out, and in 2002, the first robot-assisted hysterectomy was performed.

"Since 2011, we have known that hysterectomy should be a minimally invasive surgical practice. Open surgery applied to hysterectomy should start to disappear because endoscopic surgery offers great advantages in terms of recovery, bleeding, complications, etc," said Alcivia Smith. Laparoscopic technique has become the gold standard, and the open technique is decreasingly common.

Source: MEDspace