Robotics in Gynecology: Why is this Technology Worth Pursuing?

Abstract

Robotic laparoscopy in gynecology, which started in 2005 when the Da Vinci Surgical System (Intuitive Surgical Inc) was approved by the US Food and Drug Administration for use in gynecologic procedures, represents today a modern, safe, and precise approach to pathology in this field. Since then, a great deal of experience has accumulated, and it has been shown that there is almost no gynecological surgery that cannot be approached with this technology, namely hysterectomy, myomectomy, sacrocolpopexia, and surgery for the treatment of endometriosis. Albeit no advantages have been observed over conventional laparoscopy and some open surgical procedures, robotics do seem to be advantageous in highly complicated procedures when extensive dissection and proper anatomy reestablishment is required, as in the case of oncologic surgery. There is no doubt that implementation of better logistics in finance, training, design, and application will exert a positive effect upon robotics expansion in gynecological medicine. Contrary to expectations, we estimate that a special impact is to be seen in emerging countries where novel technologies have resulted in benefits in the organization of health care systems.

Keywords: gynecology; hysterectomy; laparoscopy; myomectomy; robotics.

Figure 1

The Da Vinci Surgical System has an ergonomic console that remotely controls the various arms of the actual robotic unit performing the surgery.

Figure 2

Training with models to enhance the abilities required for proper usage of this equipment is part of the course required to use the Da Vinci Surgical System. This robotic unit is being employed to move simple plastic models, requiring fine and precise movements.