Single-Site Robotic Gynecologic Surgery
Up and at 'em!
Linda Mozeak had a very active lifestyle – yoga, running and taking spinning classes at her local gym – until one day, without warning, the slightest strenuous activity would cause Linda to have excessive bleeding between menstrual cycles. It was a condition that forced Linda to limit the activities that were once part of her daily routine.
Doctor after doctor told her it was likely a sign of pre-menopause. “It was always shrugged off, and I was told it was an age issue and I would just have to deal with it,” says Linda, 52, of Wales, a small town near Sturbridge. “A lot of physical activity would bring it on, and I just learned to live with it by keeping myself from doing certain activities. It was a problem. My family didn’t even realize my limitations because I didn’t talk about it. “
Linda’s condition persisted for 10 years, until a new doctor discovered what was thought to be a polyp hidden in her cervix. Upon further investigation, the doctor realized the polyp was actually a tumor and could not be simply removed. Linda's doctor referred her to Brian Clark, MD, of New England Reproductive Medicine and Surgery LLC in Millbury. After meeting with and examining Linda, Dr. Clark advised her that the safest approach to resolve her problem was to have a partial hysterectomy. He discussed the various surgical options available – from the traditional open procedure to the most advanced option available, single-site robotic surgery.
“From the very beginning, Dr. Clark spent a lot of time with me," Linda recalls. "I always felt I was well-informed. He is very passionate about what he does – he is passionate about helping people, he is passionate about robotic surgery. I’ve had four C-sections. I didn’t have any reservations about single-site surgery. I wanted to get back to normal; I wanted to know what normal life was without having to deal with this issue.”
Dr. Clark scheduled the surgery for May 15, the first single-site robotic hysterectomy to be performed at Milford Regional. Linda could have chosen to have her surgery at a hospital in Worcester, which is closer to her home, but chose to have her surgery at Milford Regional due to its accessibility and the lower cost of the procedure.
Using the da Vinci ®robotic system, a port is inserted through one incision. For Linda, that incision was made following the curve of her belly button. Two long, narrow instruments and a camera were then inserted into the port. The camera allowed Dr. Clark to visualize the abdomen on a monitor at a console where he used hand-held controls to manipulate the instruments and remove the tissue.
Despite having had major surgery, Linda’s incision is barely noticeable. “You literally can’t see it,” Dr. Clark says. “The procedure fit her very well, and she fit the procedure.”
Single-site robotic surgery may not be for every patient, as there are factors to consider such as the size of the tissue that needs to be removed, the disease process, what complications may exist and the extraction process. “The recovery is substantially better," Dr. Clark explains. "There is less pain; you are moving better and you are moving sooner. It is important for us as a community to understand what our options are and for physicians to say, 'Here are all the options'. The option of minimally invasive surgery minimizes the effect on your life."
One of the factors playing into Linda’s decision was the faster recovery time afforded by single site surgery. While recovery time for minimally invasive surgery like laparoscopy (which involves multiple small incisions and less flexible instruments) is six to eight weeks, recovery for single-site robotic surgery is half the time-- three to four weeks. Linda was facing an important upcoming business trip to England. Her coworkers were amazed at her quick return to work just weeks after her surgery. Following Dr. Clark's medical direction and advice, Linda made a successful trip to England on June 9. “Dr. Clark was very thorough and we had multiple conversations before I made my decision to fly. I felt that we were working as a team,” Linda says. “I knew what to expect and to put some limitations on myself and yet not feel limited.”
Three months after her surgery, Linda felt fully recovered. Today, Linda has returned to doing all that she loves, including running with the rescue dogs she trains and cycling – in the gym and outside on the trails. “I don’t have to worry about what I am doing anymore because I don’t have the issue," Linda says with relief. "I don’t have to worry about stopping in the middle of running or spinning. I can do any physical activity without hesitation. I don’t even feel like I ever had surgery.”