Robotic Surgery & Minimally Invasive Surgery

Robotic surgery & minimally invasive surgery at a glance

  • Robotic surgeries and minimally invasive surgeries allow doctors to diagnose and treat gynecologic disorders using small incisions and precise operating instrument control that causes less trauma to tissue and results in better outcomes, less pain and faster recovery.
  • Minimally invasive surgery (known as laparoscopy) utilizes small incisions to insert special instruments and a camera that provide the surgeon with a superior view of the operation area.
  • Robotic surgery is a form of minimally invasive surgery that also utilizes a computerized robotic arm the surgeon controls to execute more delicate procedures than the human hand alone can perform.
  • These types of surgery may be used to address tubal disease, endometriosis, fibroids, ovarian cysts and other pelvic disorders affecting fertility.
  • TRM doctors only advise patients to pursue surgery when it will provide the highest chance of success when compared with more conservative treatment options.

Our approach to surgery

robotic surgery & minimally invasive surgery | Tennessee Reproductive Medicine | photo of group of surgeons in operating room

First and foremost, we want our patients to be aware of every treatment option available to them. Therefore, we only recommend surgery when it has the best potential for positive results when compared with more conservative treatment methods.

We understand all that’s involved – physically, emotionally and financially – when a patient must undergo an operation. If surgery is deemed necessary, we have the latest in minimally invasive and robotic surgery technologies at our fingertips.

In recent years, minimally invasive surgery (also known as laparoscopy and laparoscopic surgery) has fundamentally changed the way we approach gynecological disorders in the operating room. Surgeries for conditions such as tubal blockage, endometriosis, fibroids, and ovarian cysts used to require large abdominal incisions.

Today, the majority of these surgeries can be performed laparoscopically using small portal incisions, a camera and special minimally-invasive surgical instruments. This technique reduces post-operative pain and recovery time, lowers the risk of infection, and decreases blood loss. For these reasons, minimally invasive procedures generally lead to better patient outcomes when compared with traditional, open surgery techniques.

In complex cases, robotic surgery is used to gain superhuman precision and exceptional range of motion – movements that the surgeon would be unable to perform manually. Miniaturized surgical instruments are inserted through laparoscopic openings as small as half a centimeter, and a small camera is inserted through a separate incision. The doctor then controls the instruments using a high-definition video feed.

Computer-controlled scaling gives the doctor the ability to visually zoom in and out to identify areas of interest. This offers high-definition and three-dimensional visualization that enhance his/her ability to detect abnormalities.

Cases limited to abnormalities inside the uterus may be performed without any incisions. Called hysteroscopy, this minimally invasive surgery uses a small camera called a hysteroscope. The hysteroscope is a thin tube with a light that is inserted through the vagina, giving the surgeon access to the uterus using small surgical instruments.

We work in partnership with Erlanger and Parkridge hospitals to provide our patients the latest in advanced surgical technologies.

For a minority of patients, the traditional method of making a larger incision in the abdomen (laparotomy) is required. But whenever possible we employ the least-invasive surgical techniques when treating our patients. Oftentimes, more conservative treatment methods are tried before the decision is made to resort to surgery.

What conditions are treated with minimally invasive surgery & robotic surgery?

Minimally invasive surgery and robotic surgery are used to treat a variety of conditions affecting fertility.

Tubal blockage

Infertility in women is sometimes caused by a blockage in the fallopian tubes. It’s in the fallopian tubes where an egg from the ovaries is fertilized by sperm and from where the fertilized embryo moves to the uterus for implantation and pregnancy. Tubal disease is often diagnosed using an imaging procedure called a hysterosalpingogram (HSG). But sometimes surgery is needed to get a clearer picture of the blockage. Minimally invasive and robotic surgery can eliminate a tubal blockage and restore fallopian tube function.

Tubal reversal

Women who’ve undergone tubal ligation, often referred to as “getting your tubes tied,” sometimes regret having the procedure and wish to have it reversed. In some cases, this can be achieved with surgery. Prior to a tubal reversal operation, a patient’s likelihood of success will be evaluated. This evaluation includes proof of ovulation, hormone monitoring and semen analysis of the male partner.

Fibroids

Uterine fibroids are noncancerous growths in and around the uterus, and they can cause infertility as well as a number of unpleasant side effects. Fibroid growth limited to the inside of the uterus may be treated using a hysteroscope, which is inserted through the vagina in an outpatient procedure. When fibroids have spread beyond the uterus, minimally invasive and robotic surgery techniques can remove the fibroids and restore normal reproductive anatomy.

Depending on the size and location of the fibroids, the patient may be advised to pursue laparotomy – an operation involving a larger abdominal incision – if the doctor believes this method offers the best chance at removing the fibroids.

Pelvic adhesions

Pelvic adhesions are strands of scar tissue that develop between abdominal organs, usually as a result of previous surgery or disease such as endometriosis and certain sexually transmitted diseases. Adhesions near the reproductive organs can negatively impact a woman’s fertility and increase the risk of ectopic pregnancy (a pregnancy outside of the uterus that must be terminated). Laparoscopic surgery may be used to diagnose and remove pelvic adhesion scar tissue.

Ovarian cysts

Ovarian cysts are fluid-filled sacs on the ovaries that can cause ovulation dysfunction and anovulation, leading to infertility. Sometimes, medications such as birth control and hormone injections can restore normal ovulation. When these conservative measures fail or are unlikely to be effective, the doctor may elect to remove the cyst(s) using minimally invasive surgery.

Endometriosis

Endometriosis occurs when tissue from the inner lining of the uterus begins to grow outside the uterus. In addition to causing pain and discomfort, endometriosis can affect the reproductive anatomy in such a way that natural pregnancy becomes difficult or impossible.

Diagnosing endometriosis using imaging methods such as ultrasound is difficult. Minimally invasive surgery and robotic surgery may be used to evaluate a suspected case of endometriosis. Surgery can provide the doctor with a clear picture of what specifically is contributing to a woman’s struggle to conceive.

In less severe cases, surgery may be used to treat endometriosis and the associated changes to the reproductive anatomy, including tubal blockage. However, fewer than 1 in 10 women benefit from endometriosis surgery. More often, it is treated with oral medications or assisted reproductive technologies such as intrauterine insemination (IUI) and in vitro fertilization (IVF).

Risks associated with surgery

All surgery involves some degree of risk including blood loss, pain, tissue damage, blood clots, adverse reactions to anesthesia and others. Doctors discuss the risk factors associated with specific surgical procedures prior to the operation.

Additionally, surgical procedures to address fertility are not guaranteed to correct the underlying condition or improve fertility.