Robotic tools make surgery and recovery easier for local patients

by Sarah Gilbert

CHARLOTTE – When Amy Radford was unable to get pregnant, she began a journey that led her to Presbyterian Hospital and a high-tech surgery performed with robotic equipment.

Radford’s doctor at Reproductive Endocrinology Associates of Charlotte, a fertility clinic, discovered she was unable to conceive due to a series of fibroids, or benign muscle tumors, on the walls of her uterus.

“My doctor did an ultrasound and saw that the fibroids were high in my uterus,” Radford said.  “They were located in the spot where, if I were to become pregnant, the baby would want to implant.”

The doctor referred Radford to Dr. James Hardy, an OB-GYN at Presbyterian Hospital.

Hardy told Radford she needed a myomectomy, a surgical procedure to remove the fibroids.  Traditionally, a myomectomy involves making a six-inch incision in the abdomen to remove the fibroids, and it generally requires six to eight weeks of recovery time.

“Dr. Hardy said that, instead of the traditional surgery, he could do the surgery with a robot,” Radford said. “He said they would make a few small incisions instead of one big one, and there wouldn’t be a huge downtime after.”

The robot Radford referred to is part of the da Vinci system of robotic surgical instruments, which allow doctors like Hardy to perform surgery in ways they never could before.

“Traditionally, the myomectomy was done with a large incision because we needed to be able to get our hands and instruments in and touch the uterus,” Hardy said.  “With laparoscopic surgery, we make a series of small incisions and insert the instruments through them.  In this case, our largest incision was less than one inch long.”

In Radford’s case, Hardy used a laparoscope, which is a small camera, to see the fibroids, and da Vinci instruments to remove them.  Hardy removed a total of seven fibroids, ranging from half an inch to four inches long.

“Before, this patient would have needed full surgery,” Hardy said. “The robot made the surgery possible because it allows us to put the uterus back together as if we were operating through a large incision. We put a needle and suture through the port and sew the uterus up without needing a large incision.”

Performing a laparoscopic myomectomy using the da Vinci system is “very different” from the traditional procedure, according to Hardy.

“The biggest difference is we’re not directly touching the patient; we’re directly touching the instruments,” Hardy said.  “There are typically two surgeons there. One surgeon stays by the patient’s bedside to monitor them closely, and the primary surgeon goes to the console, which is a few feet away.  We sit at the console like we’re sitting at a desk, we hold the instruments in our hands and we look at what we’re doing on a TV screen.”

Operating with robotic instruments is different from operating with the laparoscope alone because the robotic instruments have wrists. Surgeons can pivot the instruments 360 degrees, just like they could if they were working with their hands through a large incision.

No large incision means less blood loss and a decreased risk of infection for the patient, as well as an easier surgical experience, Hardy said.

“This patient went home the next day, whereas she traditionally would have spent two or three nights in the hospital,” Hardy said.  “There is also a tremendous difference in the amount of pain patients feel, which lets them get back to normal activities much faster.”

For Radford, who had surgery on the afternoon of Nov. 23, the quick recovery allowed her to be moving around by Thanksgiving.

“I took it easy the first two days and took the medication like the doctors told me, but I was up and moving,” Radford said.  “I took Monday off work to be safe, but I already felt like myself again.”

Radford spent one night in the hospital following the procedure, but was impressed with how quickly she recovered, despite needing more incisions than expected.

“I had the surgery done at 12:30 (p.m.) on Tuesday … and I was discharged Wednesday evening,” Radford said.  “Surprisingly, the recovery has been even easier than I thought even though they had to do more incisions because they found more fibroids. They were able to get them all out at once.”

Having a local surgeon equipped and trained in the da Vinci system is a luxury that is not available to many women.

“The da Vinci system is not available in most hospitals,” Hardy said. “There are not many other places she could have gone in this area for such a minimally-invasive procedure. Those of us doing da Vinci surgery are very excited because it lets us do things we couldn’t do before and give our patients more options.”

At Presbyterian, surgeons have been using the technology to assist in gynecological and urological surgeries for several years.

“Presbyterian is in the process of creating a minimally-invasive surgery center here at the hospital,” Hardy said.  “The center includes robotic, laparoscopic and hysteroscopic surgery, and we want to focus on the fact that we perform the surgeries without making big incisions.”

The center’s goal is to train physicians from a variety of practices to use da Vinci so they can perform the procedures for their patients themselves, rather than having to refer them to new doctors.

“Presbyterian is actively involved in trying to promote the center,” Hardy said.  “We’re very excited about the program and think it will be very useful for women not only in Charlotte, but also in the surrounding area.”

For Radford, the surgery allowed her to start thinking about trying to get pregnant within a few short months.

“It feels like this happened a couple of weeks ago instead of a couple of days ago,” Radford said Monday, Nov. 29.  “I feel pretty much like I did before the surgery, and this was the first step toward my husband and I hopefully starting a family.”

For more information about gynecological surgery and the da Vinci equipment at Presbyterian Hospital, visit www.presbyterian.org/gynsurgery/.

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