Robotic Hysterectomy Makes a Difference

David Kushner, MD, robotic surgeryWhen Barb Thoni learned she needed a hysterectomy because she had endometrial cancer, she didn't know a robot would operate on her.
But David Kushner, MD, gynecologic oncologist, explained to her that a robot's help would let him do the surgery through small holes in her body instead of large incisions. She would have less pain and a quicker return home, he said.
"Anything that's less invasive and keeps me out of the hospital as much as possible is good," said Thoni, who was discharged the day after her procedure in January.
Hysterectomies (removal of the uterus) are among the expanding applications of robotic surgery in Madison, which is now home to two "Dr. Robots."
UW Hospital started using a robot in 2006 to remove prostate tumors and perform some heart surgeries. Doctors have now expanded the use of this technology in hysterectomies, more heart surgeries, other chest operations and additional urology surgeries.
Robotic surgery is a new form of minimally invasive surgery. That technique, also called laparoscopy, caught on in the 1990s.
In laparoscopic operations, surgeons put instruments and cameras through small holes in the body and operate while watching their work on video screens. In robotic surgery, the robot holds the instruments while the surgeon controls their movement from a nearby console.
The technology was developed for the military, to enable remote-control surgery on soldiers on the battlefield. The console gives surgeons a 3-D view inside the body. That view, along with the robot's steady hands and its extra-flexible instruments, make the surgeon's work more precise, they say, and frequently means shorter recovery times for patients.
Dr. Kushner uses the robot in most of his gynecologic surgeries. The procedures involve the removal of the uterus, along with fallopian tubes, ovaries and sometimes surrounding lymph nodes and other tissues.
Most of Kushner's patients have cervical or endometrial cancer, the most common form of uterine cancer.
Cervical cancer surgeries involve large blood vessels that can bleed, making laparoscopy without a robot somewhat risky, Dr. Kushner said.
"With the robot, you see the blood vessels before you get to them." He says. "You have such great visualization."
Diane Bridge, of Watertown, was one of Dr. Kushner's patients to undergo a robotic hysterectomy – in late 2006, for cervical cancer. She went home the next day and has remained cancerfree. It didn't bother her that a robot played a major role in her operation.
"When I'm asleep, they can do whatever, as long as it's going to help," Bridge said.
For Thoni, of Madison, surgery without the robot would have meant at least three days in the hospital. She was surprised the morning after her hysterectomy when hospital staff said she could leave.
"I was all for that," said Thoni, who has been told her cancer is gone. "My bed at home is much more comfortable."