Robot assists laparoscopic surgery
one out of nine American women will undergo a hysterectomy, a surgery to remove
all or some of the uterus, at some point in their lifetime. Ten percent of these
women will develop vaginal vault prolapse. Currently, transabdominal sacrocolpopexy
is the most effective treatment option, but it is associated with increased morbidity
compared with vaginal repairs, and many patients cannot tolerate the surgery. Researchers
from the Mayo Clinic in Rochester, Minn., recently evaluated the use of robot-assisted
laparoscopic surgery for treating vaginal vault prolapse.
The procedure involved using a computer-based
system consisting of two robotic arms, a camera arm and a remote control with three-dimensional
vision. The robot used instruments that provided the same flexibility as the human
wrist. During the surgery, the motions of the surgeon at the remote control unit
were replicated by the robotic arms placed within the patient. Technically difficult
aspects of the procedure, such as tying several knots, were both faster and easier
with the robot.
For the study, 30 patients with vaginal vault
prolapse underwent the procedure and 21 of these were analyzed about 24 months after
surgery. Twenty of the 21 patients were discharged from the hospital after an overnight
stay and reported being satisfied with the outcome of the surgery.
The researchers believe that their
results support the procedure’s use for effective treatment of posthysterectomy
vaginal vault prolapse because it results in shorter overall recovery time, less
postsurgery bleeding and less pain for the patients than the traditional procedure.
Journal of Urology, August 2006, pp. 655-659
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