Robot-Assisted Gynecological Surgery at Chilton

Facing gynecological surgery can be especially uncomfortable. Will it be painful? Will you be treated with respect? Compassion? Empathy? At Chilton, you'll experience a warm atmosphere, with expert Chilton doctors and nurses who are known for the kind of comforting care you deserve.

Whether you need a hysterectomy, or surgical treatment for pelvic organ prolapse, fibroids or stress incontinence, our superb surgeons use Chilton's advanced da Vinci® Surgical System to perform these delicate procedures with precision.

You'll have less pain, blood loss and scarring – with fewer complications, a shorter hospital stay and a quicker recovery.

It adds up to a more comfortable experience in every way. For a referral to a skilled Chilton surgeon, call 1-888-CHILTON.

• Robot-Assisted Hysterectomy (Uterus) at Chilton
• Robot-Assisted Fibroid Treatment/Myomectomy at Chilton
• Robot-Assisted Uterine and Vaginal Vault Prolapse Treatment at Chilton
• Robot-Assisted Urinary Incontinence Treatment at Chilton
• Robot-Assisted Reverse Sterilization at Chilton

Robot-Assisted Hysterectomy at Chilton

Physicians perform hysterectomy – the surgical removal of the uterus – to treat a wide variety of uterine conditions. Each year in the U.S. alone, doctors perform approximately 600,000 hysterectomies, making it the second most common surgical procedure. Types of Hysterectomy

There are various types of hysterectomy that are performed depending on the patient's diagnosis:

• Supracervical hysterectomy - removes the uterus, leaves cervix intact; This type of surgery is not recommended for women with a history of an abnormal Pap smear or certain types of pelvic pain.
• Total hysterectomy - removes the uterus and cervix
• Radical hysterectomy or modified radical hysterectomy - a more extensive surgery for gynecologic cancer that includes removing the uterus and cervix and may also remove part of the vagina, fallopian tubes, ovaries and lymph nodes in order to stage the cancer (determine how far it has spread).

Approaches to Hysterectomy

Surgeons perform the majority of hysterectomies using an "open" approach, which is through a large abdominal incision. An open approach to the hysterectomy procedure requires a 6-12 inch incision. When cancer is involved, the conventional treatment has always been open surgery using a large abdominal incision, in order to see and, if necessary, remove related structures like the cervix or the ovaries.

A second approach to hysterectomy, vaginal hysterectomy, involves removal of the uterus through the vagina, without any external incision or subsequent scarring. Surgeons most often use this minimally invasive approach if the patient's condition is benign (non-cancerous), when the uterus is normal size and the condition is limited to the uterus.

In laparoscopic hysterectomy, the uterus is removed either vaginally or through small incisions made in the abdomen. The surgeon can see the target anatomy on a standard 2D video monitor thanks to a miniaturized camera, inserted into the abdomen through the small incisions. A laparoscopic approach offers surgeons better visualization of affected structures than either vaginal or abdominal hysterectomy alone.

While minimally invasive vaginal and laparoscopic hysterectomies offer obvious potential advantages to patients over open abdominal hysterectomy – including reduced risk for complications, a shorter hospitalization and faster recovery – there are inherent drawbacks. With vaginal hysterectomy, surgeons are challenged by a small working space and lack of view to the pelvic organs. Additional conditions can make the vaginal approach difficult, including when the patient has:

• A narrow pubic arch (an area between the hip bones where they come together)
• Thick adhesions due to prior pelvic surgery, such as C-section
• Severe endometriosis
• Non-localized cancer (cancer outside the uterus) requiring more extensive tissue removal, including lymph nodes

With laparoscopic hysterectomy, surgeons may be limited in their dexterity and by 2D visualization, potentially reducing the surgeon's precision and control when compared with traditional abdominal surgery.

Benefits of da Vinci Robot-Assisted Gynecologic Surgery

Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet, open surgery can cause significant pain, physical trauma and a long recovery process. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can also cause significant anxiety.

da Vinci enables GYN surgeons to perform more complex operations through just a few tiny incisions, thereby minimizing the need to perform traditional abdominal (open) surgery. As a result, da Vinci GYN surgeons can offer the benefits of minimally invasive surgery to a broader range of patients. Potential patient benefits include:

• Shorter hospital stay (one day in most cases versus 3-5)
• Significantly less pain post-operatively (often only over-the-counter pain meds required)
• Quicker recovery and return to normal activities (1-2 weeks versus 6-8 weeks)
• Fewer complications and less risk of infection
• Less scarring: small, dime-sized incisions versus 6-8 inch scar

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient and procedure.

Learn more
If you would like to explore whether you are a candidate for robot-assisted hysterectomy, ask your doctor. For a referral to a Chilton physician, click here or call 1-888-CHILTON.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com

Fibroids and Treatment Options

Uterine fibroids* are benign (non-cancerous) tumors occurring in at least one quarter of all women. They can grow underneath the uterine lining, inside the uterine wall, or outside the uterus.

Many women don’t feel any symptoms with uterine tumors or fibroids. But for others, these fibroids can cause excessive menstrual bleeding (also called menorrhagia), abnormal periods, uterine bleeding, pain, discomfort, frequent urination and infertility. Treatments include uterine fibroid embolization – which shrinks the tumor – and surgery. Surgical treatment for uterine tumors most often involves the surgeon removing the entire uterus, via hysterectomy.

While hysterectomy is a proven way to resolve fibroids, it may not be the best surgical treatment for every woman. If, for example, you hope to later become pregnant, you may want to consider alternatives to hysterectomy like myomectomy. Myomectomy is a uterine-preserving procedure performed to remove uterine fibroids.

* Uterine fibroids are also called fibroids, uterine tumors, leiomyomata (singular – leiomyoma) and myomas or myomata (singular – myoma).

Types of Myomectomy

Each year, roughly 65,000 myomectomies are performed in the U.S. The conventional approach to myomectomy is open surgery, through a large abdominal incision. After cutting around and removing each uterine fibroid, the surgeon must carefully repair the uterine wall to minimize potential uterine bleeding, infection and scarring. Proper repair is also critical to reducing the risk of uterine rupture during future pregnancies. Menorrhagia is extensive menstrual bleeding.

While myomectomy is also performed laparoscopically, this approach can be challenging for the surgeon, and may compromise results compared to open surgery. Laparoscopic myomectomies often take longer than open abdominal myomectomies, and up to 28% are converted during surgery to an open abdominal incision.

A new category of minimally invasive myomectomy, da Vinci Myomectomy, combines the best of open and laparoscopic surgery. With the assistance of the da Vinci Surgical System – the latest evolution in robotics technology – surgeons may remove uterine fibroids through small incisions with unmatched precision and control. Benefits of da Vinci Robot-Assisted Gynecologic Surgery

Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet, open surgery can cause significant pain, physical trauma and a long recovery process. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can also cause significant anxiety.

da Vinci enables GYN surgeons to perform more complex operations through just a few tiny incisions, thereby minimizing the need to perform traditional abdominal (open) surgery. As a result, da Vinci GYN surgeons can offer the benefits of minimally invasive surgery to a broader range of patients. Potential patient benefits include:

• Shorter hospital stay (one day in most cases versus 3-5)
• Significantly less pain post-operatively (often only over-the-counter pain meds required)
• Quicker recovery and return to normal activities (1-2 weeks versus 6-8 weeks)
• Fewer complications and less risk of infection
• Less scarring: small, dime-sized incisions versus 6-8 inch scar

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient and procedure.

Learn more
If you would like to explore whether you are a candidate for robot-assisted myomectomy to treat fibroids, ask your doctor. For a referral to a Chilton physician, click here or call 1-888-CHILTON.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com

Robot-Assisted Uterine & Vaginal Vault Prolapse Treatment at Chilton

The Condition

More than 120,000 women have surgery for uterine and vaginal vault prolapse each year in the United States. Prolapse (or falling) of any pelvic floor organs (vagina, uterus, bladder or rectum) occurs when the connective tissues or muscles in the body cavity are weak and can not hold the pelvis in its natural position.

The weakening of connective tissues accelerates with age, after childbirth, with weight gain and strenuous physical labor. Women with pelvic organ prolapse typically have problems with urinary incontinence, vaginal ulceration, sexual dysfunction and/or having a bowel movement.

Women with moderate to severe uterine or vaginal vault prolapse can experience prolapse through their vagina (externally), as shown in the diagrams below. The Treatment: da Vinci Surgery for Uterine or Vaginal Vault

Sacrocolpopexy is a procedure to surgically correct vaginal vault prolapse where mesh is used to hold the vagina in the correct anatomical position. This procedure can also be performed following a hysterectomy to treat uterine prolapse to provide long-term support of the vagina. Sacrocolpopexy has traditionally been performed as an open surgery. A 15-30 cm horizontal incision is made in the lower abdomen in order to manually access the inter-abdominal organs, including the uterus.

If your doctor recommends sacrocolpopexy, you may be a candidate for a new surgical procedure called da Vinci Sacrocolpopexy. This procedure uses a state-of-the-art surgical system designed to help your surgeon perform a minimally invasive surgery through small incisions.

Benefits of da Vinci Robot-Assisted Gynecologic Surgery

Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet, open surgery can cause significant pain, physical trauma and a long recovery process. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can also cause significant anxiety.

da Vinci enables GYN surgeons to perform more complex operations through just a few tiny incisions, thereby minimizing the need to perform traditional abdominal (open) surgery. As a result, da Vinci GYN surgeons can offer the benefits of minimally invasive surgery to a broader range of patients. Potential patient benefits include:

• Shorter hospital stay (one day in most cases versus 3-5)
• Significantly less pain post-operatively (often only over-the-counter pain meds required)
• Quicker recovery and return to normal activities (1-2 weeks versus 6-8 weeks)
• Fewer complications and less risk of infection
• Less scarring: small, dime-sized incisions versus 6-8 inch scar

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient and procedure.

Learn more
If you would like to explore whether you are a candidate for robot-assisted sacrocolpopexy for prolapse treatment, ask your doctor. For a referral to a Chilton physician, click here or call 1-888-CHILTON.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com

Robot-Assisted Urinary Incontinence Treatment at Chilton

Urinary incontinence treatment, or "burch urethropexy" is also performed at Chilton with the assistance of the da Vinci Si HD Surgical System. This procedure for stress incontinence suspends the urethra to strong ligaments attached to the pubic bone (Cooper’s Ligaments). It is performed through a small abdominal incision.

Benefits of da Vinci Robot-Assisted Gynecologic Surgery

Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet, open surgery can cause significant pain, physical trauma and a long recovery process. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can also cause significant anxiety.

da Vinci enables GYN surgeons to perform more complex operations through just a few tiny incisions, thereby minimizing the need to perform traditional abdominal (open) surgery. As a result, da Vinci GYN surgeons can offer the benefits of minimally invasive surgery to a broader range of patients. Potential patient benefits include:

• Shorter hospital stay (one day in most cases versus 3-5)
• Significantly less pain post-operatively (often only over-the-counter pain meds required)
• Quicker recovery and return to normal activities (1-2 weeks versus 6-8 weeks)
• Fewer complications and less risk of infection
• Less scarring: small, dime-sized incisions versus 6-8 inch scar

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient and procedure.

Learn more
If you would like to explore whether you are a candidate for robot-assisted burch urethopexy for incontinence treatment, ask your doctor. For a referral to a Chilton physician, click here or call 1-888-CHILTON.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com

Robot-Assisted Reverse Sterilization at Chilton

For women who have undergone sterilization and would like to reverse their procedure, "tubal reanastomosis" is available with the assistance of da Vinci technology. Robot-assisted tubal reanastomosis now allows surgeons to perform sterilization reversals with all the advantages of minimally invasive procedures with far more precision than conventional laparoscopy. This translates into shorter hospital stay, with most patients returning home the same day as surgery. It also leads to lesser post-operative pain and a significantly more rapid return to normal daily activities.

Benefits of da Vinci Robot-Assisted Gynecologic Surgery

Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet, open surgery can cause significant pain, physical trauma and a long recovery process. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can also cause significant anxiety.

da Vinci enables GYN surgeons to perform more complex operations through just a few tiny incisions, thereby minimizing the need to perform traditional abdominal (open) surgery. As a result, da Vinci GYN surgeons can offer the benefits of minimally invasive surgery to a broader range of patients. Potential patient benefits include:

• Shorter hospital stay (one day in most cases versus 3-5)
• Significantly less pain post-operatively (often only over-the-counter pain meds required)
• Quicker recovery and return to normal activities (1-2 weeks versus 6-8 weeks)
• Fewer complications and less risk of infection
• Less scarring: small, dime-sized incisions versus 6-8 inch scar

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient and procedure.

Learn more
If you would like to explore whether you are a candidate for robot-assisted tubal reanastomosis for reverse sterilization, ask your doctor. For a referral to a Chilton physician, click here or call 1-888-CHILTON.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com