Lasers, Robots and an Audience of One Thousand

Antonio Gargiulo and the robotic team at BWH’s Center for Infertility and Reproductive Surgery perform a robotic reproductive surgery that is broadcast to an audience of more than 1,000 fertility surgeons.

Antonio Gargiulo, MD, medical director of Robotic Surgery at BWH, has performed hundreds of computer-assisted laparoscopic surgeries, but one he completed late last year was particularly special. 

The surgery, a robotic myomectomy to remove a uterine fibroid tumor in a 29-year-old patient, was beamed live from Brigham and Women's Faulkner Hospital to an audience of more than 1,000 fertility surgeons at the 68th annual meeting of the American Society for Reproductive Medicine (ASRM), held in San Diego. During the course of two hours, Gargiulo narrated the ongoing surgery while answering a steady stream of questions from the audience via three moderators. 

Gargiulo and members of the robotic team at BWH's Center for Infertility and Reproductive Surgery were chosen by ASRM to broadcast the procedure based on their innovative work in robotic reproductive surgery, which includes performing the first single incision robotic myomectomy in 2012. 

During the live surgery, Gargiulo used a flexible carbon dioxide laser to remove the patient's fibroid tumor. Developed at MIT, the laser can be aimed precisely and has seen success in neurosurgery and otolaryngology (ear, nose and throat) surgeries. Such focus and precision means there is little impact on surrounding tissues, which is especially important in reproductive surgeries.

Gargiulo's live robotic myomectomy also demonstrated the use of a new technique that positions the robotic arms to avoid visible scarring above the bikini line, addressing the cosmetic concerns of many patients.

The live broadcast marked another milestone for the BWH Center for Robotic Surgery, which has become the largest multispecialty robotic surgery program in the Boston area, offering a variety of urologic, gynecologic, otolaryngologic, thoracic and general surgery robotic procedures.  Since the center was established 12 years ago, BWH surgeons have performed more than 2,000 robotic surgeries-more than any other institution in the Boston area.

As director of Robotic Surgery, Gargiulo predicts that the number of robotic procedures offered at BWH will continue to grow due to the desire of patients to avoid open surgeries and the recognition of the benefits of minimally invasive surgery. These benefits include decreased blood loss and post-surgical pain, faster recovery times and decreased scarring. 

BWH, the first hospital in the region to create a detailed process to qualify its surgeons to perform robotic surgery, has developed an extensive training program for resident physicians and clinical fellows. Investments in state-of-the-art digital simulators at both BWH and BWFH provide physicians with the opportunity to refine their surgical techniques.

As for Gargiulo's star patient, whose surgery was broadcast live to the other side of the country, she left BWFH four hours after waking from her anesthesia and has made a full recovery.

Visit the BWH Center for Robotic Surgery to view videos about robotic surgery, read testimonials from BWH patients and learn about the surgeons who perform robotic procedures.  

This story was contributed by HealthHub, BWH's health blog.