Robotic-Assisted Surgery

Amanda Bennett Black
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As a nurse, Amanda Bennett Black had heard about the benefits of robotic-assisted surgeries.

But it wasn’t until she found out she needed to have a hysterectomy that she experienced those benefits first-hand.

“It really is a blessing to have that option,” Black said. “I had heard about it and now to experience it, I’m speechless.”

An abnormal pap smear and follow-up biopsy that showed pre-cancerous cells led to her having her uterus, fallopian tubes and one ovary removed on Aug. 20.

Black, an assistant nurse manager at AdventHealth Gordon, opted to have a robotic hysterectomy at the recommendation of her physician, Joy Nwadike, MD, a board-certified obstetrician and gynecologist with AdventHealth Medical Group OB/GYN.

“Robotics has improved hysterectomy outcomes in a remarkable way,” Dr. Nwadike said. “It’s a safer way to do surgery, a more effective way to do surgery and a more efficient way to do surgery. There’s less pain and a more optimal surgical outcome.”

That’s because the robot-guided technology used to perform the surgery relies on instruments inserted through small incisions in the patient’s abdomen. Through the use of a console next to the patient, the surgeon can precisely control the instruments, which mimic the movement of human hands, wrists and fingers. Cameras attached to the instruments provide the physician with a magnified and 3-dimensional view of the operating field.

“With the robot, you don’t have all the tissue trauma and blood loss,” Dr. Nwadike said. “The fact that I can see better means it’s safer for the patient to avoid injury. I can manipulate (the instruments) without traumatizing the tissue.”

Less blood loss and tissue damage mean patients regain their energy soon after surgery and can return to their pre-surgical lives more quickly than had they received a traditional hysterectomy.

“It’s truly a minimally invasive surgery,” Dr. Nwadike said.

Black agreed, saying her recovery lived up to what Dr. Nwadike prepared her for.

“I was surprised how tiny those incisions were,” she said. “Now I can understand why the healing time is minimal.”

Black only spent four hours at the hospital for the prep, surgery and post-operative care before being discharged to recover at home.

“By the next day, I was walking and taking it easy,” she said. “I was off the pain meds completely two days after.”

Dr. Nwadike said most patients with desk jobs can return to work within two weeks. Those with more physically demanding jobs, like Black, typically go back to work in four to six weeks.

“Even though you feel like you’ve healed, you haven’t healed completely, so you still want to take it easy,” Black said. “I know robotic surgery has not been out very long, but I would encourage women to just talk to their doctors, talk to people who have had it done and hear their side of the story and ask as many questions as you can.”

Physicians at AdventHealth Gordon began performing robotic-assisted surgeries in 2015 when Hak Lee, MD, a urologic oncologist who leads the hospital’s robotics program, joined the team and began sharing the benefits of the high-tech equipment.

Dr. Nwadike and Donald Taylor, MD, also with AdventHealth Medical Group OB/GYN, were among some of the first surgeons at AdventHealth Gordon to see the benefits it brought to patient care.

“The more traditional surgeries are vaginal hysterectomy, abdominal hysterectomy or laparoscopic-assisted vaginal hysterectomy,” Dr. Taylor said. “I was used to doing all of those, especially laparoscopic-assisted hysterectomies for 10 to 15 years or more, and we got really good at it, but what we found when we started working with the robotics and using their tools was such an ease of using those tools and the visualization was so much better because now we have a three dimensional view.”

Other benefits included less blood loss during the procedure, which lowered the number of patients needing blood transfusions, reduced scarring and provided a lower risk of infection.

“One of the risks of hysterectomy is later on with the vagina losing its support, and with a robotic hysterectomy, we maintain the ligament support to the vagina, so they’re less likely to undergo repeat surgeries for prolapse,” Dr. Taylor said.

Dr. Taylor said most women needing hysterectomies are candidates for a robotic procedure, but there are exceptions, including those who have a particularly large mass or enlarged uterus.

Dr. Nwadike said she performed her 100th robotic surgery in September and is now exploring the viability of using the technology for reconstructive surgeries.

“One of the things that increases the quality of life and longevity to combat morbidity is having access to health care and technology that improves the way we deliver health care,” Dr. Nwadike said.

“For a small town like Calhoun and AdventHealth having the foresight to provide this, that says a lot of this company because they’re looking at making sure the patients in their service are not only being looked after but looked after in a good way.”

Black agreed, saying she was grateful to not have to travel out of town to receive a robot-assisted surgery, especially when she knew from experience that she would be cared for by well-trained and compassionate health care professionals who would put her at ease every step of the way.

“To be on the other side of it, other than as a staff member, and to experience it, it’s great to know I work for a hospital that really does care for you and they do hold up to their mission to Extend the Healing Ministry of Christ,” she said. “I can’t stress enough about the great experience I had.”

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