da Vinci® Hysterectomy
(Early Stage Cancer Surgery)
If your doctor recommends a hysterectomy for gynecologic cancer, you may be a candidate for minimally invasive da Vinci Surgery.
Why da Vinci Surgery?
With the da Vinci System, surgeons operate through a few small incisions instead of a large open incision - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision, dexterity and control.
As a result of da Vinci technology, da Vinci Hysterectomy offers the following potential benefits compared to traditional open surgery:
- More precise removal of cancerous tissue (based on two year follow-up)1
- Fewer complications1,2,3,4,5,6,7
- Less blood loss1,2,3,4,5,6,7,8
- Less pain7,9
- Shorter hospital stay (one day in many cases)1.2,3,4,5,7,8
- Quicker recovery6
- Small incisions for minimal scarring
As a result of da Vinci technology, da Vinci Hysterectomy offers the following potential benefits compared to traditional laparoscopy:
- Similar or fewer complications,6 including major complications10,11
- Fewer conversions to open surgery8,10,12
- Less blood loss3,5,10
- Less need for narcotic pain medicine13
- Shorter hospital stay5,8,10
- Quicker recovery6
State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. da Vinci – taking surgery beyond the limits of the human hand.
Physicians have used the da Vinci System successfully worldwide in approximately 1.5 million various surgical procedures to date. da Vinci is changing the experience of surgery for people around the world.
Risks & Considerations Related to Hysterectomy & da Vinci Surgery
Potential risks of any hysterectomy procedure include:
- Separation of the vaginal incision
- Blocked lung artery
- Urinary tract injury
In addition, there are risks related to minimally invasive surgery, including da Vinci Hysterectomy, such as hernia (bulging tissue at incision site).5
- Lau S, Vaknin Z, Ramana-Kumar AV, Halliday D, Franco EL, Gotlieb WH. Outcomes and cost comparisons after introducing a robotics program for endometrial cancer surgery. Obstet Gynecol. 2012 Apr;119(4):717-24. doi: 10.1097/AOG.0b013e31824c0956.
- Paley PJ, Veljovich DS, Shah CA, Everett EN, Bondurant AE, Drescher CW, Peters WA 3rd. Surgical outcomes in gynecologic oncology in the era of robotics: analysis of first 1000 cases. Am J Obstet Gynecol. 2011 Jun;204(6):551.e1-9. Epub 2011 Mar 16.
- Estape R, Lambrou N, Estape E, Vega O, Ojea T. Robotic-assisted total laparoscopic hysterectomy and staging for the treatment of endometrial cancer: a comparison with conventional laparoscopy and abdominal approaches. J Robotic Surg 2009 DOI 10.1007/s11701-011-0290-7.
- DeNardis SA, Holloway RW, Bigsby GE, Pikaart DP, Ahmad S, and Finkler NJ. Robotically assisted laparoscopic hysterectomy versus total abdominal hysterectomy and lymphadenectomy for endometrial cancer. Gynecologic Oncology 2008;111:412-417.
- Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, and Fowler WC. A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer. Am J Obstet Gynecol 2008. (For port placement, see figure 3)
- Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, and Hunt S. Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy, and robotic techniques. Gynecologic Oncology III 2008:407-411.
- Halliday D, Lau S, Vaknin Z, Deland C, Levental M, McNamara E, Gotlieb R, Kaufer R, HowJ, Cohen E, Gotlieb W. Robotic radical hysterectomy: comparison of outcomes and cost. J Robotic Surg (2010) 4:211–216 DOI 10.1007/s11701-010-0205-z
- Magrina JF, Zanagnolo V, Giles D, Noble BN, Kho RM, Magtibay PM. Robotic surgery for endometrial cancer: comparison of perioperative outcomes and recurrence with laparoscopy, vaginal/laparoscopy and laparotomy. Eur J Gynaecol Oncol. 2011;32(5):476-80.
- Lowe MP, Hoekstra AV, Jairam-Thodla A, Singh DK, Buttin BM, Lurain JR and Schink JC. A comparison of robot-assisted and traditional radical hysterectomy for early-stage cervical cancer. Journal of Robotic Surgery 2009:1-5.
- Lim PC, Kang E, Park do H. A comparative detail analysis of the learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of the first one hundred twenty two patients. Gynecol Oncol. 2011 Mar;120(3):413-8. Epub 2010 Dec 30.
- Jason D. Wright, MD, Cande V. Ananth, PhD, MPH Sharyn N. Lewin, MD William M. Burke, MD Yu-Shiang Lu, MS,Alfred I. Neugut, MD, PhD Thomas J. Herzog, MD, Dawn L. Hershman, MD. JAMA, February 20, 2013—Vol 309, No. 7 689.
- Scandola M, Grespan L, Vicentini M, Fiorini P. Robot-assisted laparoscopic hysterectomy vs traditional laparoscopic hysterectomy: five metaanalyses J Minim Invasive Gynecol. 2011 Nov-Dec;18(6):705-15.
- Martino MA, Shubella J, Thomas MB, Morcrette RM, Schindler J, Williams S, Boulay R. A cost analysis of postoperative management in endometrial cancer patients treated by robotics versus laparoscopic approach. Gynecol Oncol. 2011 Dec;123(3):528-31. Epub 2011 Oct 2.
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.
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PN 1002185 Rev A 04/2013