[MUSIC]
Minimally invasive surgery is a way of performing procedures
through tiny incisions in the anterior abdominal wall.
We can do the same kind of procedures that we used to
perform through large open incisions,
using tiny cameras and small instruments.
That allows us to see everything in the pelvis and the abdomen
and use instruments to remove structures like the uterus.
Perform hysterectomies, and staging procedures for
cancer that allow us to take better care of patients than we
would have with a large, open incision.
[MUSIC]
There's a number of minimally invasive surgical options for
patients treated for
gynecological conditions here at Hopkins.
Those include conventional laparoscopy,
where we perform the procedure through several small incisions
in the entire abdominal wall, usually three or four.
There's robotic surgery in which we can perform the same
types of procedures through the existence of a robotic platform,
again, through three or four, or at most five,
incisions all through the abdominal wall.
The single-site platform allows us to perform similar types of
procedures through one incision through the belly button.
These tend to be limited to more straightforward cases, but
as we've grown more experienced with using the platform,
we're able to do increasingly complex procedures through one
small incision in the abdominal wall.
[MUSIC]
The majority of our patients here at Hopkins
undergo a minimally invasive surgery for gynecologic cancers.
Those include those with early stage uterine, cervical, and
ovarian cancers that need surgical staging.
Where we remove the organ that's involved and
perform additional procedures to remove lymph nodes and
other structures that might be involved with cancer.
[MUSIC]
Minimally invasive surgery is an option for
most, but not all, patients with gynecologic cancers.
For patients that have disease that's spread outside of
the organ where the disease starts,
especially diseases like ovarian cancer, an open approach is
still the best way to get all of the cancer out.
For patients that have more limited disease,
minimally invasive surgery really is the way to go in
the majority of situations.
The risks of minimally invasive surgery are very
similar to those that you see with open surgery.
Those can include complications from any surgical procedure,
however, they are generally lower than with open incisions.
There really are very few situations where a patient is at
increased risk from minimally invasive surgery,
especially in the hands of an experienced surgeon.
[MUSIC]
The benefits of minimally invasive surgery are improved
recovery time and
decreased complications when compared to open surgery.
It's important to also note that the outcomes, as far as treating
the cancer, are also equivalent between the two.
So, whenever possible,
minimally invasive surgery is prefered because of the reduced
complication rates with this technique.
[MUSIC]
The need for chemotherapy or radiation after surgery is
not generally dependant on the approach of surgery.
That being said, when patients have minimally invasive surgery,
they tend to recover better from the procedure and are able to
get onto their post operative therapy, if necessary, faster
than if they had the surgery through an open technique.
This is especially the case when complications arise.
These are much less common with minimally invasive surgery, so
it allows patients to get on with the treatment that they
need to get much faster.
[MUSIC]
Recovery from minimally invasive surgery tends to be excellent.
Patients are able to go home either the same day or
the day after surgery, and they require usually very
little pain medication for only a few days and are back doing
normal activities within a few weeks of the procedure.
Obviously, it depends on the extent of the procedure, but
most patients are feeling fairly well within a few weeks.
[MUSIC]
Gynecologic oncologists are capable of taking care of
the full scope of care for
a patient with a gynecologic cancer.
We're able to provide preoperative counseling to allow
patients to understand exactly what they can anticipate
from surgery.
Whether that's a straightforward hysterectomy, or if we have to
do additional procedures like removing lymph nodes or
other procedures in the operating room.
Here at Hopkins, we also provide our own chemotherapy care.
This provides seamless continuity for patients who
really need a team leader to take care of their conditions.
We can see a patient in the clinic, offer them surgery,
arrange and provide chemotherapy for them afterwards, and
follow them in the years to come.
[MUSIC]
Here at Johns Hopkins, we have a comprehensive program for
providing all options for minimally invasive surgery for
patients with suspected or known gynecologic cancers.
We can provide procedures for
laparoscopy robotic single incision surgery, and
we'll spend time to decide which approach is most appropriate for
patients so they receive optimal care.
[MUSIC]