Frequently Asked Questions
Questions & Answers about MIS
Q.
Are MIS procedures (laparoscopic and robot procedures) as proven as standard surgery through an incision?
A.
There has been more than 20 years of worldwide experience that has shown them to be equivalent by all standards, especially cure rates and low complications rates if performed by experienced surgeons. NCS surgeons have been pioneers in many MIS procedures including robotic surgeries with the da Vinci® surgery system.
Q.
What is the difference between the same procedure performed through an open incision and one performed with laparoscopic instruments or robotics (MIS)?
A.
The actual procedure and tissues removed are the same. The major difference is that with MIS procedures there are four or five small incisions used instead of a large vertical (up and down) incision with standard surgery. Additionally, with laparoscopic and robotics procedures, there is greater light, magnification and dexterity compared to standard surgery. These benefits of minimally invasive surgery (MIS) lead to decreased pain, faster recovery and less bleeding.
Q.
What is the experience of NCS surgeons with MIS surgery?
A.
NCS surgeons have been pioneers in this area for 20 years. Not only do we lead the region in the number of cases but we have performed many “firsts” on both a local and national scale. We have also adapted these technologies for fertility-sparing procedures (saving part of the uterus and ovaries) even in the face of cancer.
Q.
Can fertility-sparing procedures (saving part of the uterus and ovaries) be done without MIS techniques?
A.
Yes but MIS techniques allow greater care with delicate tissues and better control of bleeding. The result is less damage to the function of the organs needed to become pregnant.
Q.
Are all patients candidates for MIS?
A.
No, that decision is made on a case-by-case basis in a discussion between patient and surgeon. We encourage all patients to seek a second opinion regardless of that decision.
Q.
Are there any disadvantages to MIS procedures when compared to those done through a standard incision?
A.
Not many. The procedure usually, but not always, takes longer in MIS surgery. This means longer time under anesthesia but the associated risk to the patient is very slight. Otherwise all other factors favor MIS procedures over standard open surgery as MIS benefits include less pain, shorter hospital stay, reduced bleeding, and shorter time to resume normal activities.
Q.
What about the fact that the abdomen is filled with carbon dioxide (CO2). Can this be harmful to the patient?
A.
CO2 is inert which means it causes no interaction with the body. But if the levels in the blood get too high it can displace oxygen. However, this is monitored constantly by the anesthesiologist. The CO2 can cause irritation to the diaphragm, the muscle under your lungs. This can lead to referred pain in the shoulder (the pain is felt there). The excess CO2 usually gets absorbed quickly and the pain soon goes away.
Q.
Are there any long-term differences between standard open surgery and MIS surgery?
A.
Not really. As stated, cure rates and complications are similar. In the short term patients recover faster and better with MIS procedures. In the longer term (6+ months) there is no major difference between the two procedures with the exception that MIS surgery leaves much smaller scars. There is also the possibility for greater risk of hernias with a large incision than with MIS incisions but this has not been measured.
Questions & Answers about Robotics
Q.
What is robotics-assisted surgery?
A.
Robotic-assisted surgery is a method of surgery based on minimally invasive surgery or MIS. By dramatically enhancing visualization, precision, control and dexterity, robotic-assisted surgical systems help physicians perform complex surgery in a manner never before experienced.
Q.
What is the name of the robot used by NCS surgeons?
A.
NCS physicians are trained on the da Vinci Surgical System for robotic-assisted surgeries. Made by Intuitive Surgical, the robotic system is called “da Vinci” in part because Leonardo da Vinci invented the first robot. He was also known for his unparalleled anatomical accuracy and the use of three-dimensional details to bring his masterpieces to life. The da Vinci Surgical System similarly provides physicians with such enhanced detail and precision that the System can simulate an open surgical environment while allowing operation through tiny incisions.
Q.
Where do NCS surgeons perform da Vinci robotic surgeries?
A.
Currently, NCS physicians are performing robotic procedures for treating gynecologic cancers at Legacy Good Samaritan Hospital, Providence St. Vincent Medical Center and Southwest Washington Medical Center.
Q.
How does the surgeon control the da Vinci systems?
A.
The surgeon operates while seated at a console and sees true-to-life three-dimensional images of the operative field. The surgeon’s fingers grasp the master controls below the display, with hands and wrists naturally positioned relative to his or her eyes. The surgeon’s commands are executed via the patient-side cart, where four robotic arms and specially designed instruments translate the surgeon’s hand, wrist and finger movements into real-time movements inside the patient. Watch a video of the da Vinci system at work.
Q.
What are the benefits for surgeons who perform robotic-assisted surgery over more traditional methods of surgery?
A.
Some of the major benefits experienced by surgeons using the da Vinci Surgical System over traditional approaches have been greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access.
Q.
What are the benefits for patients associated with robotic-assisted surgery?
During robotic-assisted surgery, patients typically experience less blood loss (fewer transfusions) and less pain. Also, because incisions are much smaller and patients experience less trauma than in open surgery, patient benefits may include a shorter hospital stay, less pain, less risk of infection, less blood loss, fewer transfusions, less scarring, faster recovery and a quicker return to normal daily activities. None of these benefits can be guaranteed, as surgery can be both patient- and procedure-specific. Read success stories from some of our patients.
