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A team of reproductive surgeons at the BWH Center for Robotic Surgery at Faulkner Hospital is on the forefront of innovation for myomectomy, or surgical removal of uterine fibroids. Last fall, they performed the first-ever single port robotic myomectomy in the world. Since then, the procedure has been successfully replicated.
As many as one in five women have uterine fibroids, which are noncancerous tumors in the uterus. If the fibroids cause pain or pressure, abnormal bleeding or interfere with reproduction, they may need to be surgically removed. No medical cure exists yet for uterine fibroids.
“BW/F has a history of innovation in the field of single incision laparoscopic surgery,” said Antonio Gargiulo, MD, director of Robotic Surgery at Brigham and Women’s Center for Infertility and Reproductive Surgery. “In 2010, the minimally invasive gynecology team had reported the first-ever non-robotic single port myomectomy. Our robotic procedure now opens the door to the new field of ultra-minimally invasive computer-assisted reproductive surgery.”
According to Gargiulo, single incision laparoscopic surgery is now a well-established minimally invasive technique, but it poses very serious technical limitations on a number of levels. “Now that we are able to use the da Vinci Robot in single incision surgery, we have increased dexterity and three-dimensional vision, and many of the problems we previously faced—including instrument crowding at the level of the single abdominal incision—are no longer an issue,” said Gargiulo
In carefully selected patients, this revolutionary procedure offers many benefits over traditional surgery.
“Traditional open surgery requires one large incision and retraction to accommodate human hands, but only small incisions are required for the robot’s hands,” said Serene Srouji, MD, associate director of Robotic Surgery. “The hands of the robot are attached to four arms – one guides a high definition 3-D camera, two act as the surgeon’s main arms and an optional arm is often used for holding back tissue.”
Since 2007, Gargiulo’s team has performed more than 500 standard robotic surgery cases, most of them myomectomies. Gargiulo says the collaborative nature of the work done at BWH and Faulkner Hospital also plays a role.
“We want to radically change the face of gynecologic surgery to improve the patient experience in New England and beyond,” said Gargiulo. “It is just part of our vision of being at the very center of clinical research, education and patient care. As a result, one cautious but decisive step at a time, we are able to accomplish revolutionary things.”