Minimally Invasive Surgery for Gynecologic Cancer | Q&A


[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]

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