|September 2007 · Vol. 19, No. 09
HOW DEVELOPMENTS ARE CHANGING PATIENT CARE
Is robotics practical for gynecologic surgery? And will laparoscopy become obsolete?
The gynecologic laparoscopic procedures best suited to the robot are sacral colpopexy, myomectomy, radical hysterectomy, and lymph node dissection
Natural orifice transluminal endoscopic surgery appears to be the next true advance in minimally invasive surgery
If the need for transabdominal access is eliminated, the risk of intraoperative intestinal and major vessel injury should be dramatically reduced
OBG Management Board of Editors
Dr. Levy is Medical Director of the Women’s Health Center of the Franciscan Health System in Federal Way, Wash.
The author reports no financial relationships relevant to this article.
Over its history, surgery has been defined by the tools available to practitioners. In our era, opportunities to offer patients minimally invasive surgery have expanded dramatically as methods of establishing visualization, achieving hemostasis, and performing tissue dissection have improved. (I remember trying to treat ectopic pregnancy laparoscopically in the early 1980s without benefit of a camera or suction irrigator!)
For surgeons of my generation, the ability to access the abdominal cavity minimally invasively and to clearly visualize the contents was a significant step forward. Hysteroscopic myomectomy was another tremendous incremental improvement for patients with submucous myomas. But there is much more in store for the coming years.