Medically Reviewed by J. Michael Davidson, MD
Endometriosis – when the lining of the uterus grows elsewhere in the pelvis – can be painful, even dangerous, if left untreated. McLeod Gynecologist Dr. J. Michael Davidson describes a robot-assisted surgical approach to treating endometriosis.
Here’s a summary of Dr. Davidson’s comments:
Robotic assistance helps make a more precise diagnosis because we can use the robotic instrument to see the tissue in a better way by giving the patient a dye that makes the endometriosis show up better. When we do find the endometriosis, it’s much easier to treat and remove it in its entirety and do a better job of completing that treatment.
With traditional laparoscopy, the surgeon is seeing things through monocular (single lens) vision. So, it’s not the preciseness you have with robotics, where you have two lenses and binocular vision. The degree of sharpness with which you can see it is much better. When you’re ready to treat the endometriosis, you can be more precise with the robot than with longer instruments that have to be manipulated with traditional laparoscopy.
The recovery for laparoscopic and for robotic-assisted surgery are similar. Most patients are able to return to normal activities within a few days. Any strenuous activities — if they have a job or family obligations that require any lifting — require that they wait anywhere from 10 days to two weeks to do that.
With robotic-assisted removal, you don’t have to manipulate the tissue as much. The surgeon can be more precise with the removal of the endometriosis tissue. The patient has less scarring, less pain and a better result, in many cases, than you’re able to obtain with what we call straight stick or regular laparoscopy.
Some patients with endometriosis don’t have any symptoms, and they won’t have any progression of their disease. It could be an incidental finding in another surgery. Progressive or advancing endometriosis can spread and act almost like cancer, where it starts to incorporate the tissue around it. Scarring can lead to problems with fertility as well as problems with the bowel or bladder. If it progresses, then it could ultimately require a hysterectomy or other major surgery.
I think the main thing for women to know is that if they’re experiencing pain and discomfort, pain with intercourse, pain with cycles that’s new or different, endometriosis is a definite possibility. This should be investigated and treated so that it doesn’t progress or worsen and cause problems with fertility or problems that could result, ultimately, in a hysterectomy.
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