How Technology Impacts Gynecology Surgery

How Technology Impacts Gynecology Surgery

Phoenix Buchanan, Medical Director of Obstetrics and Gynecology, Jackson Memorial Hospital

Phoenix Buchanan, Medical Director of Obstetrics and Gynecology, Jackson Memorial Hospital

The healthcare sector is using enhanced surgical techniques in vaginal surgeries to achieve the desired outcome. 

Hysterectomies are now conducted by utilizing many different techniques. These include abdominal, vaginal, laparoscopic, laparoscopic-assisted vaginal hysterectomy and robotic-assisted laparoscopic hysterectomy. These techniques offer the surgeon and the patient options to choose the most beneficial and optimal surgery method. It causes additional difficulties in structuring programs for gynecological surgical education. These problems may lead to shifts in surgical exposure for residents away from both abdominal and vaginal methods. 

A more minimally invasive surgical approach is an important current trend in gynecologic surgery. Vaginal and laparoscopic surgery and the addition of robotic-assisted surgery are all compatible with shorter hospital stays, quick recovery of patients, less blood loss, less infection, and increased patient satisfaction. Surgical training for gynecological surgeons should be designed to produce reliable, well-trained doctors with a diverse surgical background consistent with surgery progress.

Traditional guidelines for hysterectomy

Abdominal

• Vagina “Too Narrow” (Arch <90deg., Bituberus diameter <8.0cm

• Intra-Abdominal issues

• Uterus "Too Big"

• -Adhesions, endo, adenexal disease, prev. Pelvic surgery, CPP, prev. Cesarean

• Uterus “Too High” (no descent)

Vaginal

A less medical condition, mainly prolapse. Abdominal surgery has the highest complication rate with higher costs related to complications from surgical techniques, and vaginal surgery continues to have the lowest price and difficulties.

Laparoscope

Harry Reich performed his first hysterectomy with the help of a laparoscope in 1988. The laparoscope supported the surgeon with smaller incisions in the abdomen and pelvis analysis, and the uterus was removed through the vagina. Less pain, less blood loss, and shorter hospitalization and recovery are associated with this surgical combination. In addition to the learning curve, the laparoscope still incorporated price and OR time.

Robotics

A laparoscopic surgical technique is still considered robotic-assisted surgery, but it incorporates a three-dimensional camera, enhanced ergonomics, seven degrees of freedom compared to a surgeon's hand, and offers accurate, precise instrument control. The critical defect of robotics in surgery is a haptic failure and increased costs. The DaVinci robotic system costs approximately $1.6 million, plus an annual expense of two hundred and fifty to five hundred dollars for servicing and surgical instruments. However, robotics eliminates several of the negative aspects of laparoscopic surgery, such as lack of ergonomics, surgeon amplified tremor, fulcrum, two-dimensional camera, and a restricted four-degree freedom range motion.

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