Robotic Gynecologic Surgery
Getting Your Life Back Again
“The pain that I was in would take my breath away,” says Julie Dean, 42, referring to her menstrual cramps. As she got older, the Milford resident says her periods had gotten heavier and more painful—almost unbearable and even debilitating. She assumed that the pain was a normal part of the aging process. Over time, however, she began to feel extremely lethargic, sometimes even taking a nap while working at her demanding job in finance.
This past January, Julie met with Melissa J. Clough, MD, an obstetrician/gynecologist and robotic surgeon at Milford Regional, to talk about her symptoms. After blood work revealed that Julie was anemic, Dr. Clough performed additional tests to confirm that Julie had a large fibroid tumor inside her uterus as well as one on the outside. She also had precancerous cells on her cervix. Ultimately, Julie needed to undergo a hysterectomy.
When Julie first heard the news, she had flashbacks to the C-section she underwent to deliver her now 19-year-old daughter. “I remembered the pain of the C-section,” she recalls. “It was awful. I was nervous especially because they used staples back then.”
The good news is that nearly two decades later, Julie had options, including an innovative and minimally-invasive approach that would be less painful, cause less scarring and allow her to recover more quickly than an open procedure— robotic-assisted surgery using the da Vinci Surgical System.
Robotic-assisted surgery allows physicians to perform delicate operations, such as a hysterectomy, with superior vision, precision, dexterity and control—all through a few tiny incisions. The approach provides an alternative for women like Julie who don’t want to undergo a complicated open procedure and who might otherwise simply live—and suffer—with the pain.
Patients undergoing a robotic-assisted hysterectomy usually spend fewer than 24 hours in the hospital and are back at work as soon as two weeks after the procedure. With an open procedure, women don’t usually return to work until six to eight weeks after surgery. Women undergoing the robotic approach also experience less postoperative pain, and the risk for wound infection is also greatly reduced. In addition, with an open incision, women can’t usually drive for three to four weeks. With robotic surgery, they can drive as soon as a week after the procedure.
Julie met with Dr. Clough to talk about her options, which included either an open, laparoscopic or robotic-assisted procedure. She ultimately chose the robotic approach because of the quicker recovery time. “It wasn’t a difficult decision,” Julie says. “Dr. Clough made me feel like she was my sister or my family member. She made me feel very at ease and very comfortable in choosing the robotic procedure.”
Dr. Clough, who has been using the da Vinci system for more than a year, received intensive training, including didactic learning, case observations, and proctored surgeries under the guidance of a practicing robotic surgeon. Because of her level of expertise, Dr. Clough is now a robotics proctor herself. “It’s wonderful to be able to help a woman solve a health problem in a way that minimizes her pain and shortens her recovery,” she says.
During the procedure, Dr. Clough placed trocars (long cylindrical sleeves) through small keyhole incisions into Julie’s abdomen. She inserted special robotic arm-like instruments through the trocars and then used a computer console to control the robot’s movements while looking at a 3-D visualization. The robotic instruments provide Dr. Clough with a greater range of motion that she doesn’t have when using linear laparoscopic instruments that only allow her to work in a straight line. “With robotics, the instruments are wristed. I can turn them more than 360 degrees,” she explains. “I can perform more delicate and precise surgery just as I would if I were holding an instrument in my hand with an open case. I can take my static clamp or scissor and then turn the angle to match a woman’s anatomy and then easily and gracefully do the work that I need to do.”
Julie stayed only one night at Milford Regional and says staff members were “always attentive.” Her pain was manageable, requiring her to take only a low dose of pain medication. “Before I knew it, the pain was gone,” she says, adding that she was able to go back to work after four weeks. Her incisions are so small that she says they look like freckles. Today, she’s happy to report that she can resume her four-mile walks and is no longer tired at work. She’s looking forward to going back to the gym to begin strength and conditioning classes again.
She encourages other women to consider the robotic approach rather than suffering needlessly with pain. “You’ll get your life back again,” she adds.
Go to In Their Own Words