- Resection of Endometriosis
- Surgery for Uterine Cancers
- Surgery for Cervical Cancer
- Surgery for Ovarian Cancer
As an experienced advanced minimally invasive surgeon, many of Dr. Elizabeth Poynor's cases are completed through a standard laparoscopic approach. However, robotic assistance is employed to convert some of the most complex surgical procedures, once only performed with large incisions, into ones performed with small "band aid" or "key hole" incisions.
Myomas, also commonly referred to as fibroids, are benign tumors that arise from the muscular wall of the uterus(womb). They are very common in women and when large, may lead to pelvic pain, heavy vaginal bleeding, or infertility. A myomectomy removes these benign tumors, while leaving the uterus intact. The procedure is generally done for women who desire to have their fibroids removed and retain their uterus, largely for childbearing reasons.
Robotic surgery has advanced the management of these tumors so that larger myomas, which were once only removed through large abdominal incisions, can be safely and efficiently removed through minimally invasive surgical techniques.
A hysterectomy refers to the removal of the uterus (womb). If the entire uterus, including the cervix (the opening to the womb) is removed, the procedure is referred to as a total hysterectomy. If the cervix is left in place, it is referred to as a supracervical hysterectomy. A hysterectomy may be recommended to a woman for many reasons including: symptomatic fibroids, adenomyosis, abnormal bleeding, endometriosis, pre cancers or cancer.
Many times, a woman's uterus can be removed through minimally invasive surgical techniques, such as vaginally or with the standard laparoscope. However, women who have other conditions that make the hysterectomy more complex may benefit from the assistance of the robot at the time of minimally invasive surgery.
Endometriosis is a condition in which endometrial tissue, the tissue lining the inside of the uterus (womb), is found in other locations of the body. This misplaced endometrial tissue can lead to extensive scarring in the pelvis, the most common location for endometriosis. This scarring can in turn lead to infertility and severe pelvic pain. Some women can be managed with medical maneuvers such as birth control pills and other types of hormonal interventions. However, some women may be recommended to undergo surgical removal of the endometriosis implants, with our without removal of the ovaries and uterus.
This surgery can be quite complex as this disease can involve the colon, rectum, bladder and ureters. In the past, many of these operations required a large abdominal incision. A laparoscopic procedure performed with the heightened visualization and instrumentation that robotic assistance can provide, can greatly aide in this type of advanced laparoscopic procedure, making it more feasible to be performed with minimally invasive techniques.
Surgery for cancer of the uterus (womb) typically involves the removal of the uterus, cervix, fallopian tubes and ovaries. The surgery may also entail removal of lymph nodes in the pelvis and in the upper abdomen, also referred to as a staging procedure. Although many times this procedure can be accomplished through the standard laparoscope, robotic assistance can help the surgeon perform this procedure.
Surgery for early stage cancer of the cervix (the opening of the womb) entails the removal of the uterus and the cervix with its tumor and surrounding tissues, referred to as a radical hysterectomy. In this operation lymph nodes in the pelvis are also removed. For some women who desire to preserve fertility, only the cervix with its tumor and surrounding tissues will be removed, a radical trachelectomy, leaving the uterus in place for future child bearing. These procedures have been greatly aided with the development of robotic surgery, so that well selected women may be able to undergo their surgery with a minimally invasive approach.
For well selected individuals with ovarian cancer, minimally invasive surgical techniques can be employed. While the majority of women with ovarian cancer will still be recommended to undergo a standard approach with an incision, some may be offered a minimally invasive approach. These women typically have smaller tumors amenable to this type of surgery, or may have isolated areas of disease recurrence. Standard staging of ovarian cancer, which once required a large abdominal incision, can now be performed through the small minimally invasive incisions. The heightened visualization and instrumentation of the robot can greatly aid this complex surgery.