The case report in the Journal of Minimal Access Surgery is of a 46-year-old physically fit female with a history of excessive bleeding and benign growths on her uterus. Her surgery was performed through a two inch-long incision in the belly button, the thinnest part of the abdomen, using the robotic arms in a "chopstick" fashion, said Dr. John R. Lue, Chief of the Medical College of Georgia Section of General Obstetrics and Gynecology at Georgia Health Sciences University.
"This paper helps show it can be done," said Lue, corresponding author. "Now we need to do large studies to find which women would most benefit and whether it can be done for more significant pathology such as large fibroids and cancer." Cost effectiveness also needs to be assessed, he noted.
A multi-inch incision across the pubic hair line is the approach for the majority of hysterectomies in the United States. Another option – one that minimizes pain, scarring and recovery time – is laparoscopy, a decade-old approach involving multiple, smaller abdominal incisions that provide access for a two-dimensional camera and surgical instruments.
Robotics, which enables three-dimensional imaging and directing surgical moves from a console, improves mobility and surgical control but typically requires multiple small incisions, Lue said. The single point of entry adds improved aesthetics to its list of benefits, he said.
"It's like an extension of your own hand being inside the patient," Lue said of the fine control and access of robotics. "You can see the anatomy much clearer. I can see each blood vessel streaming blood and where your nerves are. You can see the ureter much clearer," he said, noting injury to this connector between the kidney and bladder is a known risk of laparoscopic hysterectomy.
The downside is the robotic technique can be tough to learn: physicians essentially work in reverse since the single point of entry requires the chopstick approach that leaves the right hand doing what the left typically would. "You have to think opposite of what you normally do," said Lue, who began using robotics about five years ago on cases such as large fibroids that were difficult to remove laparoscopically.
Single-incision robotics is being used for an increasing number of surgeries such as prostate cancer, gallbladder disease and removal of a donor kidney for transplant. One relatively new obstetric use is to put a stitch in the cervix to prevent premature delivery, an approach Lue now utilizes. Surgeons from the Yonsei University College of Medicine in Korea reported on the use of robotic single-port total hysterectomies in seven patients in 2011 in the Journal of Gynecology Oncology for benign disease and cervical cancer.
Toni Baker | EurekAlert!
Virtual Reality in Medicine: New Opportunities for Diagnostics and Surgical Planning
07.12.2016 | Universität Basel
3-D printed kidney phantoms aid nuclear medicine dosing calibration
06.12.2016 | Society of Nuclear Medicine
Physicists of the University of Würzburg have made an astonishing discovery in a specific type of topological insulators. The effect is due to the structure of the materials used. The researchers have now published their work in the journal Science.
Topological insulators are currently the hot topic in physics according to the newspaper Neue Zürcher Zeitung. Only a few weeks ago, their importance was...
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
09.12.2016 | Life Sciences
09.12.2016 | Ecology, The Environment and Conservation
09.12.2016 | Health and Medicine