Robot technology is now being used for certain types of gynecological surgery at FirstHealth Moore Regional Hospital.

Use of the da Vinci Robotic Surgical System allows gynecologists to perform some complex hysterectomies, as well as uterine fibroid removal and pelvic support reconstruction, as minimally invasive procedures. Because the operations are done through a few tiny incisions instead of one large one, patients typically have less pain, shorter hospital stays and much faster recovery.

With robot-assisted procedures, the surgeon sits at a console a few feet from the patient and guides the movement of surgical instruments at the end of the robot's arms. Two cameras mounted on a scope, which is inserted through a small incision, transmit three-dimensional video images of the surgical field to a monitor in front of the console, giving the surgeon a remarkably clear view.

"The visualization is unprecedented," says Dr. Walter Fasolak, an obstetrician and gynecologist with Southern Pines Women's Health Center. "The two cameras at the tip of the scope are within an inch or two of what you're operating on, so you've got a beautiful view that fills the screen."

Dr. Stephen Szabo, an OB/GYN specialist with Pinehurst Surgical, says the robotic system allows him to maneuver surgical instruments more precisely than is possible with conventional laparoscopic surgery.

"When you are sitting at the console and controlling the instrument, it's almost like the instrument is in the palm of your hand," he says. "It's much like the feeling of open-incision surgery. Suturing is more precise, and dissecting tissue to identify veins and arteries is easier and more controlled. The system is designed to be like an extension of your body, so you think it and it happens."

The technology allows physicians to offer more patients the benefits of minimally invasive surgery.

"I can do more difficult, complex cases on patients who otherwise wouldn't be able to have laparoscopic surgery," Szabo says. "The robot allows me to take a big, conventional open surgery and turn it into a surgery where the patient is going to go home the same day or the next day and will be pretty much back to normal in a week rather than a month."

Many hysterectomies can now be done as laparoscopic procedures, but some require large, open incisions. With the robotic system, more of those difficult hysterectomies can be performed laparoscopically.

The robot also makes it easier to remove uterine fibroids while preserving the structure of the uterus. That is particularly important, Fasolak says, when a woman wants to keep her uterus intact so she can have children, but the fibroids need to come off because they are keeping her from becoming pregnant or are causing her to miscarry.

Surgery to provide support for pelvic organs that have dropped because of weak muscles or ligaments is another procedure that can be done through small incisions with the help of the robot. This involves stitching a mesh material to the vagina and then anchoring it to the lower spine to create a supportive sling.

"It involves a lot of sewing, and the robot speeds that up tremendously," Fasolak says.

Fasolak describes the robotic system as a major advance in gynecologic surgery.

"There is tremendous satisfaction in being able to offer it to patients, because they are certainly going to benefit from it," he says.

Szabo says only a couple of his patients have expressed concern that they were going to be operated on by a robot. He assured them that the robot does nothing on its own.

"We control everything," he says.

Robotic surgical systems are found mostly at major medical centers. So far, very few hospitals the size of Moore Regional have them. Moore Regional acquired its da Vinci surgical system in early 2006, and local urologists have been using it for more than two years to perform prostate surgery.

While emphasizing that the technology is not appropriate for all patients, Dr. Fasolak calls robotic surgery "a fabulous tool that the hospital has acquired and the physicians here have stepped up to use."

Anyone needing more information on robot-assisted surgery at FirstHealth Moore Regional Hospital, can call (800) 213-3284.