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Advances in Robotic Surgery

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Physicians reviewing case

When Susan Cramer’s mother had gynecologic surgery in 1973, she was in the hospital for nine days and spent two months recovering. When Cramer, now 54, had a robotic-assisted radical hysterectomy for ovarian cancer this January, she was out of the hospital the next day and back to her routine as soon as she got home.

“I couldn’t believe the results,” says Cramer, who traveled from West Virginia to have her surgery at Pennsylvania Hospital. “I didn’t even need pain medication after 48 hours. It really was a miracle.”

Diagnosed with stage III ovarian cancer, Cramer researched her options and found Thomas Randall, MD, director of gynecologic oncology at Pennsylvania Hospital. She met with Dr. Randall, and was so impressed by the team at Penn Medicine, that she chose to have her surgery in Philadelphia – more than 250 miles away from her home.

“Surgery for gynecologic cancer used to mean open surgery with more risk for complications and a longer recovery time,” says Dr. Randall. “Today, with the technology and experience we have at Penn, we can remove the cancer so women can move forward with their treatment plans sooner.”

More Surgical Options

Robotic-assisted surgery is like other minimally invasive surgery in that instruments and cameras are inserted through small incisions in the body. In robotic surgery, however, the surgeon sits at a console next to the patient. Looking through a viewfinder in the console, he or she uses hand and foot controls to move the surgical “arms.”

“We can see more with the robot because it allows us to go deeper into the body without compromising control or sight,” says Dr. Randall. “We use 3-D binoculars while we operate that actually allow us to see more clearly than if we were performing traditional minimally invasive surgery.”

Robotic-assisted surgery also requires smaller incisions, so there is less blood loss and a shorter hospital stay. It is an ideal option for women with a lot of scar tissue or who are obese. “Most women I see are candidates for robotic-assisted surgery,” says Dr. Randall. “This type of surgery can actually reduce the amount of scar tissue and adhesions from surgery.”

Dr. Randall says most robotic surgeries he performs are for endometrial and cervical cancer. While using robotic surgery to treat ovarian cancer is a recent development, Dr. Randall says the efforts of the Penn Ovarian Cancer Research Center (OCRC), led by George Coukos, MD, have helped provide women with ovarian cancer more innovative treatment options. The OCRC’s major initiative, immunotherapy uses a patient’s own tumor tissue to develop cancer vaccines and therapeutic lymphocytes. The Center collects, transports, processes and stores the tumor tissue of both Penn and non-Penn patients — providing every woman with ovarian cancer access to personalized tumor vaccines. The OCRC’s innovative approaches to treating ovarian cancer work to improve survival rates and enable women affected by this disease to enjoy a better quality of life.

Experience Driving Technology

Penn is home to eight da Vinci® Surgical Systems, making it one of the largest robotic-assisted surgical programs in the United States. However, the experience of the surgical team is what really makes Penn’s program stand out.

Dr. Randall is a national expert in robotic-assisted gynecologic surgery, and has performed more than 800 robotic-assisted surgeries since 2007.“Everyone on our surgical team is an early adopter of technology,” says Dr. Randall.

Gynecologic oncologists at Pennsylvania Hospital are part of a multidisciplinary team of cancer specialists that work together to create a tailored treatment plan for every patient.

For Susan Cramer, the physician experience combined with advanced technology meant more than just a few tiny incisions; it meant getting valuable time back thanks to a quicker recovery.

To schedule an appointment or learn more about gynecologic oncology services available at Penn, call 800.789.PENN(7366) or visit here.

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