Brigham and Women’s Hospital’s (BWH) Center for Infertility and Reproductive Surgery is a national leader in using state-of-the-art robotics to improve reproductive surgery outcomes. This cutting-edge technology’s ability to broaden the scope of minimally invasive surgery is compelling more and more of the Center’s patients to consider robotic laparoscopic surgery as a safe and effective means of preserving their fertility and, in select cases, enhancing outcomes for subsequent assisted reproductive technology (ART) procedures. Leaders in the Field
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 also performed Boston’s first robot-assisted hybrid myomectomy for the removal of very large myomata. They have since continued this accomplished partnership to perform more than 100 robot-assisted surgeries at BWH. In addition to reversal of tubal ligation and myomectomy, Drs. Gargiulo and Srouji can also use the robot to perform other types of complex laparoscopies such as procedures to remove pelvic endometriosis. Gargiulo and Srouji are also leading advocates of the technology, regularly teaching robotic procedures to observers from throughout the world.
Drs. Gargiulo and Srouji employ the da Vinci Surgical System’s miniaturization, precision, dexterity, and enhanced vision to maximize their 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 main 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. However, these movements are always guided by a doctor, never programmed.
To get a sense of the clarity and magnification provided by the robotic camera and the nimble movements enabled by the robotic arms, watch the following video featuring detailed footage of a myomectomy performed by Drs. Gargiulo and Srouji – “Conventional Laparoscopic Myomectomy with Robotic Reconstruction: A Safe Hybrid Procedure for Large Myomata.” You can also 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.
Patient Benefits
This miniaturization, increased range of motion, enhanced vision, and mechanical precision ultimately allow for virtually all reproductive surgeries to be performed laparoscopically. This translates to definitive benefits for Gargiulo and Srouji’s 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
Drs. Gargiulo and Srouji’s patients also have particular appreciation for how important the robot’s precision is to the reconstructive aspect of reproductive surgery – critical for maintaining a woman’s fertility.
Despite these well-known benefits, most gynecologic procedures today are still being performed with traditional open surgery techniques. This is largely because the techniques are difficult to learn and teach, and that is why patients are coming to BWH to be treated by surgeons who have significant experience and demonstrable skills in laparoscopic and robotic surgery.
Learn More
If you would like to learn more about robotic surgery or would like to schedule an appointment, please contact BWH’s physician referral service at 1-800-BWH-9999.
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