Women's Connection: Robotic Hysterectomy

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Nearly 200 women attended Tuesday’s Women’s Connection luncheon at Abode Venue, where we had the opportunity to try operating one of Via Christi’s da Vinci Robotic Surgery Systems and hearing board-certified OB-Gyn Matthew Voth, MD, explain the minimally invasive gynecological procedures done with the system.

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Women's Connection: Robotic Hysterectomy

  1. 1. Rapid Recovery: How RoboticSurgery Benefits WomenMatthew Voth, MD, OB-GynVia Christi Clinic
  2. 2. Hysterectomy  Most common GYN procedure  1/3 of women by age 60  620,000 per year  73% for benign conditions
  3. 3. Reasons for Hysterectomy  Irregular bleeding  Painful periods  Persistent abnormal pap smears  Uterine prolapse  Cancer
  4. 4. Types of Hysterectomy  Total  Partial  Radical
  5. 5. Abdominal Vaginal Laparoscopic TotalAssisted Vaginal Laparoscopic
  6. 6. Which one to choose? VS.
  7. 7. What are we thinking?  Safest route  Shortest recovery  Experience with procedure  Long term outcome  Alternatives
  8. 8. What should YOU be thinking?  Effectiveness  Shortest recovery  Long term outcomes  Alternatives??
  9. 9. Alternatives  IUD  Combined Hormone Therapy  Lysteda  Endometrial Ablation  Uterine Artery Embolization
  10. 10. Abdominal Hysterectomy  Long considered standard  Better visualization  Tactile advantage  EBL 300-500 cc’s  3 day hospitalization  4-6 week recovery
  11. 11. Vaginal Hysterectomy  No abdominal incisions  EBL 200-500 cc’s  1-2 day hospitalization  2-4 week recovery  Proper patient selection
  12. 12. Laparascopic Assisted Vaginal  Faster recovery than abdominal approach  3-4 small incisions  EBL 100-300 cc’s  2-4 week recovery  Easier to get ovaries/adhesions
  13. 13. Total Laparoscopic Hysterectomy  100% completed from above  Cervix can be left (controversial)  Morcellator  EBL 50-500 cc’s  1-4 week recovery
  14. 14. In an ideal world.....  Vaginal hysterectomy
  15. 15. Surgery  Options to consider
  16. 16. da Vinci Robot
  17. 17. Advantages  Can tackle ALMOST everything  Recovery of Laparoscopy, visualization better than open procedure  Maneuverability of instruments  Fast
  18. 18. What to Expect  1 hour surgery  Recover 2 hours, then to room  Catheter out 4-6 hours post-op  No restriction on eating  Home the same day or following morning
  19. 19. What to Expect… continued  Narcotics the first several days  50% of patients, pain med free at 7 days  Back to work in 1-3 weeks
  20. 20. RestrictionsVERY IMPORTANT  No lifting> 20# for 6 weeks  No intercourse for 6 weeks
  21. 21. Random Thoughts  Ovarian preservation  Hormone replacement therapy
  22. 22. Robotic Surgery
  23. 23. Robotic Surgery Questions?

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