Minimally Invasive Surgery Checklist
- Patients with ovarian cancer may be eligible for minimally invasive surgery
- Minimally invasive surgeries usually require only a 5 to 8 millimeter incision
- Minimally invasive surgery results in less scarring and faster recovery than open surgery
- Robotic assisted surgery is significantly more expensive than open surgery, however when you factor in a shorter recovery, the costs can end up being similar
If you have small volume disease, your doctor may choose a minimally invasive approach for surgery. “The difference between a minimally invasive surgery and open surgery is that we’re able to thread instruments through small incisions, usually about five to eight millimeters,” says Dr. Sarah Todd, gynecologic oncologist at the University of Louisville.
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In traditional open surgery for ovarian cancer, doctors make a large incision in the abdomen in order gain access to diseased tissue both in the ovaries and in the surrounding organs of the abdomen and pelvis. “The advantages of this traditional approach are tremendous, especially if you’re dealing with large volume disease,” Dr. Todd says.
With a minimally invasive approach, doctors are able to perform surgery through very small “ports” in the abdomen or pelvis. While the abdominal incisions for laparoscopic surgery are much smaller than for traditional surgery, doctors need multiple incisions to perform the procedure. Each small incision allows a light or a surgical tool access to the internal organs.
The Robotic Advantage
There are different ways to approach minimally invasive surgery. Some surgeons prefer traditional laparoscopic surgery where the surgeon is at your side working the instruments with their own hands. Others perform minimally invasive surgery using robotic assistance. The advantage with the robotic approach is increased dexterity.
“You have seven degrees of articulation of the wrist of a robotic instrument, which is actually greater than a human wrist, as well as magnification to about 10 times of what you might see with the naked eye,” Dr. Todd says. “You also have the ergonomic benefit of being able to sit at the console as opposed to standing at the bedside and having to manipulate your body to get the right angle.” Still, it’s up to the provider to choose the approach they’re most comfortable with.
Side Effects of Laparoscopic Surgery
The side effects of ovarian surgery depend, in large part, on which approach the surgeon takes for the procedure. If a patient has early stage disease and doctors are able to use a lower-risk, minimally invasive approach, complications are usually minimal and affect only the areas that are being sampled or removed.
High risk areas include:
- The bladder
- The intestines
- The ureter (the connection between the kidneys and the bladder)
- The blood vessels and nerves that course next to the lymph nodes
In most cases, the side effects for a laparoscopic approach are minimal and resolve shortly after surgery. Plus, in general the side effects and the pain are much less than what a patient might experience with traditional open surgery.
Not sure which approach is best for you? Talk to your doctor. In almost every case, your surgeon will perform the procedure that will remove as much disease as possible while also minimizing the impact on surrounding structures.
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