The Surgical Management Of Gynaecological Disorders

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The surgical management of gynaecological disorders has progressed dramatically with the introduction of minimally invasive laparoscopic techniques. The recent application of robotic technology for minimally invasive surgery is an additional refinement that has been widely adopted in the United States and elsewhere. Although this is not supported by evidence-based studies on cost, clinical outcomes and patient safety, the ergonomic design of the console minimizes operator fatigue and muscle strain. As for minimally invasive surgery, a significant learning curve is associated with mastering this technique. The current literature on robotic surgery for gynaecology is limited in that it is observational, retrospective, or anecdotal. Only a…show more content…
Today, robot technology is applied widely in gynaecology for hysterectomy, sacrocolpopexy, myomectomy, adnexal surgery, and malignancy staging. Its use for gynaecological conditions in developed countries has grown rapidly [1]. In the United States, robot-assisted surgery currently is performed at more than 2000 hospitals. Growth in hospital ownership of robotic systems parallels the increase in the volume of robotic-assisted procedures, which is in excess of 25% annually [1,3]. This growth has been driven by multiple factors: surgeons’ preference, patient attraction to new technology, industry pressures, and marketing efforts of hospitals and surgeons. Doctors and hospitals often promote and advertise robotic surgery, even though their claims of better outcomes and safety [4,5] remain largely unsubstantiated. Technical Aspects The most widely used system – the da Vinci robotic platform - consists of three components: the surgeon’s console, which directs the movements of the robotic arms, the visualisation apparatus and the patient-side cart, which in the latest system has four arms. Four to five trocars are used, including one through which a 8-mm or 12-mm three-dimensional endoscope is placed. Instruments are introduced through these ports, three of which can be controlled by the robotic arms and one or more controlled by human assistants. After the introduction of port sites and docking the patient side

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