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How does Robotic Surgery used in Gynecology?

How does Robotic Surgery used in Gynecology?

You performed a live Laparoscopic Surgery on the broadcast. What is the importance of this live broadcast?

In 2009, we started to perform Single-Port Laparoscopic Hysterectomy. Later on, the Robotic Surgery has developed, and established in Ege University. In January 2013, we started to perform Single-Port Laparoscopic Hysterectomy with the help of Robotic Surgery techniques. Then, we have been offered to perform this surgery on a live broadcast in a gynecology congress. First, I was invited to this gynecology congress which was held in Washington, USA. After giving a speech at this conference, we had performed Single-Port Laparoscopic Hysterectomy with the help of Robotic Surgery techniques on a live broadcast. Gynecologists who attended the conference from 80 countries all around the World were very interested in this method. They asked many questions about the surgery, and I had the chance to show them the surgery on a live broadcast. In this successful live broadcast, we performed the surgery in 50 minutes without any bleeding whatsoever. We received many appreciations thru messages and direct contact. We were very proud to perform this surgery live, the first time in Turkey.

What is Robotic Surgery?

The surgeon sits on a console. This console provides the surgeon the chance of moving the robotic arms like they are the surgeon’s own arms. The biggest advantage is to perform the surgery in 3d with a lot of detail on the screen in front of you. We managed to perform even the tiniest moves delicately and successfully. Previously, we couldn't perform these tiny moves so well because of hand trembling. Thanks to the Robotic Technologies, the hand trembling reduced to 0, allowing us to perform very successful surgeries even in the most sensitive locations.

Is it hard to operate using Robotics?

You need to get training to perform the surgery with the robotic technologies. After the training, you can perform many operations. Robotic Technology also provides a lot of advantages and it makes many of the surgeries quite easy. In normal laparoscopy, we can perform the surgery in 2D. Robotic Technology provides us the chance to operate in 3D, offering many advantages. It really makes things a lot easier.

In which problems the robotic surgery can be used?

The method we use is Single-Port surgery. The fact that people do not want a scar on their body inspired the creation of this method. Surgeons find a way to use a natural hole for performing the surgery and the development of the method started. In this method, the patient’s belly button is used as a single port. A 2cm-wide, small incision is made on this natural hole. After the procedure, sutures are made on the incision and the scar will not be visible because it is inside the belly button. Different procedures can be performed later using the same hole but it is not possible to do it all in a single hole yet, the procedure is still in development progress. Myomas, Chocolate Cysts (Ovarian Endometriomas), Uterine removal, cancer surgeries, and urinary incontinence can be treated using this method. As one of the most performed procedures, an obstruction on the ovarian canal can be eliminated as well. This is a challenging operation and using robotic Technologies, we can perform this operation very well.

What are the advantages of Robotic Surgery?

As one of the major advantages, the patient can be discharged for home rest, just one day after the surgery. The patient can start walking, experience less pain and less risk of infection on the scar. It also brings happiness to the family who is waiting for the return of the patient at home. If the patient is working, the loss of workforce will be minimized because the patient can go back to work sooner. In open surgeries, the abdominal tissue is in contact with the air and it might cause cohesion. Using the robotic technologies, the tissue-air contact is way lesser than open surgeries and the risk of cohesion is lower.

Are there any risks in this method?

Like in all kinds of surgeries, Robotic Surgery also has risk but it is no more compared to other methods. For example, the risk caused by anesthesia is the same compared to other surgeries. There are no other risks apart from that.

Is there an experience of temporary pain in robotic surgery?

Pain can be experienced after all kinds of surgeries. Compared to open surgeries, the pain is significantly less with the robotic surgery, and the pain is expected to wear off in a couple of days after the surgery.

Should the patient avoid situations such as heavy lifting?

Basically, the patient can do anything one day after the surgery. Of course, there are some things patients need to avoid. But there are no limitations for walking, bending, leaning or twisting because there isn't a big healing scar after the surgery. After the surgery, the patients can go back to their daily routine easily.

Is Robotic Surgery can be applied to overweight women?

Open surgery might cause trouble for overweight women. There are some cases which open surgery must be performed, and open surgery can be performed if your surgeon is better on open surgery techniques. But our goal is to provide robotic surgery techniques on as many women as possible. The biggest problem with overweight patients is the healing process. Because of the excessive fat tissue, healing takes a lot of time and the risk of infection escalates. Robotic surgery minimizes these kinds of risks on closed surgeries.

When can I get pregnant after a myomectomy?

It depends on the location of the myoma. I am advising my patients to use birth control for 3 months after having the surgery. They can try to get pregnant after this period.

Does closed surgery reduce the time to get pregnant?

It depends on the patient's lifestyle. But the important issue is the healing of uterus. The healing process is almost the same in both open and closed surgeries.

Do you provide training for robotic surgery?

We think that it is important to spread the usage of this technique in Turkey, which is really important for women’s health. Our goal is to spread robotic surgery techniques all over Turkey, to be used on as many women as possible. In order to do that, our government must contribute to establishing the required systems and surgeons must be trained accordingly. Especially gynecologists must be trained if they did not receive this training during their residency or if they are thinking that the training they have is not enough.

Is there a demand for the training programs?

Our colleagues had to travel outside the country for getting this training because there wasn't any training program established in Turkey. In 2008, we started a robotic surgery training program in Turkey. After that, there was a huge demand and we provided training programs until 2018.

If there is Ovarian Aging on early ages, Should IVF treatment must be had?

If a woman wants to get pregnant, while experiencing Ovarian Aging, immediate action must be taken. In Ovarian Aging, the ovaries lose their function more and more, every day. In this situation, if a woman has healthy eggs, the IVF treatment will be a shortcut to achieve pregnancy. So, starting the IVF treatment will be suitable for the purpose of getting pregnant.


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