Gynecologic surgeon Ricardo Estape, M.D., performed South Florida’s first single-incision robotic hysterectomy today at South Miami Hospital.
Dr. Estape, who has performed thousands of robotic gynecologic surgeries over the past seven years at Baptist Health, had awaited FDA approval of the single-site hysterectomy since single-incision gallbladder surgery was approved in December 2011. This past February, the FDA approved usage of the instrumentation on the robot that allows surgeons to enter a patient’s body through the bellybutton and remove the uterus, fallopian tubes and ovaries.
“This approach is truly revolutionary in a surgery that used to leave a large scar between the bellybutton and pubic bone,” Dr. Estape said. “Patients are often concerned about the scars left after surgery, and we have evolved our approach to minimize those scars. Now, patients will be left only with a scar within the natural folds of their navel.”
During the surgery, Dr. Estape made a 2.5 centimeter incision in the patient’s bellybutton. This allows a port, or tube, to be placed in the opening. Through this port, the robot’s camera and two arm-like structures enter the patient’s abdomen.
Dr. Estape then sat at a console in the operating room and used his hands and feet to control the arms and instruments inside the patient’s body, while looking at a 3-D, high-definition view of the organs provided by the camera.
Once the surgery was completed, the robot was removed from the patient and Dr. Estape used stitches to close the incision.
“Patients are usually out of the operating room in less than an hour and out of the hospital the next day,” Dr. Estape said. “They resume normal activities within a couple of weeks.”
In addition to a hidden scar, the benefits of this surgical approach to the patient include less blood loss, fewer complications and a quicker recovery. Risks are similar to other types of surgery and include infection, post-operative bleeding and reaction to anesthesia. These should be discussed with a doctor prior to surgery.
So far, this single-incision approach to hysterectomy has only been FDA-approved to treat benign conditions requiring a hysterectomy and removal of the ovaries and fallopian tubes.