Robotic surgery shortens recovery time, reduces pain

A revolutionary surgical procedure at Erlanger is helping women like La Verne Easterly get back on their feet within a few days after a hysterectomy—a sharp contrast to the normal six-to-eight week recovery period for a traditional hysterectomy.

At one time women requiring a complex hysterectomy had only one option: a total abdominal hysterectomy. This traditional treatment method involved a lengthy abdominal incision, considerable pain and discomfort, a hospital stay of several days, and up to eight weeks of restricted activity.

Innovations in tiny surgical instruments soon led to the laparoscopic hysterecto my, a minimally invasive procedure that reduces the physical impact of major surgery. But technological advancements like Erlanger’s da Vinci “S” surgical system take minimally invasive procedures one step further, dramatically reducing hospitalization and recovery times for many women, including Mrs. Easterly of Cleveland, Tenn.

When an ultrasound test revealed a cyst on Mrs. Easterly’s right ovary last year, gynecologist James Abell, M.D., of Beacon OB/GYN, immediately referred his patient to Stephen DePasquale, M.D., gynecologic oncologist with Chattanooga’s Program for Women’s Oncology, for a hysterectomy.

With no symptoms of ovarian cancer and no family history of the disease, Mrs. Easterly initially resisted the idea of major surgery that would put her out of commission for several months—until Dr. DePasquale indicated she was an ideal candidate for a robotic laparoscopic hysterectomy using the da Vinci “S” surgical system at Erlanger.

The da Vinci system allows Dr. DePasquale to operate through small, dime-sized abdominal incisions and direct robotic “arms” to perform the surgery with a variety of tiny surgical instruments. Seated at a console, Dr. DePasquale views the surgical area through a tiny, endoscopic camera that reveals three-dimensional images magnified 14 times greater than what the human eye can see. The controls at the console allow the physician to move the robotic “hands” with precision, eliminating the natural tremor of even the steadiest of human hands.

Patients undergoing robotic surgery typically go home the same day and return to normal activity much more quickly than with open gynecologic surgeries. “My entire procedure took less than 12 hours from start to finish—including the drive time to and from our home in Cleveland to the Erlanger Baroness Campus,” Mrs. Easterly explains.

“Many da Vinci patients—like Mrs. Easterly—return home the same day,” says Dr. DePasquale, who has four years of experience with robotic surgery and has performed nearly 200 cases of complex gynecologic surgeries, including female cancers, with the da Vinci.

“Robotic surgery dramatically reduces recovery time. The small incisions typically result in decreased blood loss, a lower risk of infection, fewer transfusions, less scarring, and faster recovery,” adds Dr. DePasquale. “Also, the da Vinci “S” system at Erlanger has expanded the use of gynecologic laparoscopic surgery to now include endometrial and cervical cancers, as well as low-to-moderate risk ovarian masses.”

“Between the positive and professional attitude of Dr. DePasquale and the personnel at Erlanger, I went into surgery with no fear,” adds Mrs. Easterly, who was impressed with the pleasant atmosphere at Erlanger. “I actually asked Erlanger employees if they were required to take a course in being so nice and tolerant of their patients!”

Showing no signs of cancer, Mrs. Easterly, 65, returned home after surgery and with the exception of heavy lifting, quickly resumed normal activities. “The day after my surgery, I went up and down the stairs in my home several times, and I was never bedridden. Within a week, I resumed working and driving. Robotic surgery made all the difference.”

Dr. DePasquale, of Chattanooga’s Program for Women’s Oncology, along with Donald Chamberlain, M.D., of Chattanooga GYN-Oncology, are the only two gynecologic oncologists currently performing hysterectomies and other gynecologic surgeries using the da Vinci surgical system at Erlanger.