Brigham and Women’s Hospital (BWH) is a world leader in using state-of-the-art robotics to improve surgical outcomes. This cutting-edge technology’s potential to broaden the scope of minimally invasive (laparoscopic) surgery and shorten patient recovery time is compelling more and more of our patients to consider robot-assisted surgery.
BWH surgeons use the FDA-approved da Vinci Surgical System to perform a variety of urologic, gynecologic, and general laparoscopic procedures. These currently include radical prostatectomy, radical and partial nephrectomy (kidney cancer removal), cystectomy (bladder removal), tubal reanastomosis (tubal sterilization reversal), myomectomy (uterine fibroid removal), bariatric surgery, radical hysterectomy, and specialized hysterectomies for cervical and uterine cancers. This variety, and volume, will continue to grow as surgeon experience and demand increase.
Enhancing Surgical Skills
Robotic surgery uses the primary advantages of miniaturization, precision, dexterity, and increased vision to enhance surgical skills and improve patient outcomes.
Traditional open surgery requires one large incision and retraction to accommodate human hands, but only small incisions are required for the robot’s hands. These hands are attached to four available arms – one guides a high definition 3-D camera, two act as the surgeon’s arms and an optional arm is often used for holding back tissue. The camera gives the surgeon enhanced detail, true depth of field and a panoramic view, and the robotic hands’ broad range of movement gives the surgeon greater dexterity. These capabilities are further enhanced by unique ergonomics that help to ease surgeon fatigue and precise mechanics that enable steady movements. Notably, these movements are always guided by a qualified surgeon, never programmed.
Patient Benefits
This miniaturization, increased range of motion, enhanced vision, and mechanical precision ultimately lead to significant benefits for our patients, such as:
- Less blood loss
- Less post-surgical pain/less medication
- Quicker recovery and return to normal activities
- Less scarring
- Less likelihood of complications
Leaders in the Field
BWH is the site of New England’s first successful robot-assisted laparoscopic tubal sterilization reversal and first robot-assisted radical hysterectomy. BWH’s surgeons, however, are not only leading practitioners of robotic surgery, but also devoted advocates of the technology. They regularly welcome national and international observers and teach robotic procedures to their peers.
Read below for an overview of the robot-assisted procedures that our surgeons perform.
Radical Prostatectomy
Radical prostatectomy is currently the most commonly performed robot-assisted laparoscopic surgery. Jim C. Hu, MD, MPH, Director of Minimally Invasive Urologic Oncology, is a national leader in this field, having performed more than 400 robot-assisted radical prostatectomies at BWH and more than 450 such surgeries before launching BWH’s program in 2005. He is also one of only a few doctors in the US to have participated in a one-year fellowship dedicated to robotic surgery. In addition to the common robotic surgery benefits noted above, Dr. Hu’s patients have also experienced a quicker recovery of sexual function and continence.
Watch the Prostate Cancer video to see an example of one patient’s experience with robot-assisted surgery, watch Robot-Assisted Prostatectomy Videos to see surgical footage of five important stages of a robot-assisted prostatectomy, or visit the Robotic and Minimally Invasive Surgery page to learn more about the procedure. Robot-Assisted Reproductive Surgery
Antonio R. Gargiulo, MD and Serene Srouji, MD launched BWH’s Robot-Assisted Reproductive Surgery program when they performed New England’s first successful robot-assisted laparoscopic tubal sterilization reversal in January 2007. Shortly thereafter, in February 2007, they were the first in Boston to perform a minimally invasive myomectomy (uterine fibroid removal) that used both laparoscopic and robotic techniques. Drs. Gargiulo and Srouji have since continued this accomplished partnership to perform more than 100 robot-assisted surgeries at BWH. In addition to the common robotic surgery benefits noted above, Drs. Gargiulo and Srouji’s patients have also come to appreciate how important the robot’s precision is to the reconstructive aspect of reproductive surgery.
Watch "Robotic Myomectomy: The Latest Tool In Fertility-Enhancing Surgery" or “Myomectomy and Radical Hysterectomy with Robotic Assistance” to see and hear patients’ experiences with robot-assisted myomectomy, from their consideration of the surgery to their recovery. If you would like to see the procedure being performed, watch an award-winning video that features detailed footage of robotic surgery performed by Drs. Gargiulo and Srouji. Visit the Robot-Assisted Reproductive Surgery page to learn even more about the procedures or to schedule an appointment.
Radical Hysterectomy
Colleen M. Feltmate, MD, Director of Minimally Invasive Surgery in Gynecologic Oncology, and Michael G. Muto, MD, performed the first radical hysterectomy in New England in September of 2006. Since that time, the Gynecologic Oncology department has completed more than 100 robot-assisted radical hysterectomy procedures for patients with cervical or endometrial cancers and nearly all radical hysterectomy procedures are now done laparoscopically. In addition to the common robotic surgery benefits noted above, the da Vinci robot also helps gynecological patients to maintain continence and provides an alternative to some obese patients who normally wouldn’t qualify for laparoscopic surgery.
Watch the “Myomectomy and Radical Hysterectomy with Robotic Assistance” video to see an example of one patient’s robotic-assisted radical hysterectomy experience or visit the Advanced Minimally Invasive Surgery for Patients with Gynecologic Cancers page to learn more about the procedure.
