Publication:

Application of Robotic Surgery in the treatment of endometriosis: View point of an Indian OBGYN fellow in USA

Background This article is an observational experience of robotic surgery in USA by an Indian Obgyn fellow. Primary objective is to analyze retrospectively peri operative outcomes in stage 2 and 3 Endometriosis treated with robot assisted laparoscopy. Secondary objective is to report an Indian Obgyn, Physician observer fellows experience in USA with Robotic surgery.

Methods 29 women underwent robotic surgery at in the department of gynecology at Doctor’s hospital, Baptist health, Miami. Pre-op time, console time, total operative time, blood loss, peri-operative complications noted.

Results Mean age is 42 ± 8 years with BMI of 26.2 ± 8 kg/m2. Eighteen patients (62%) were age 40 and above. Twenty patients (69%) presented with chronic pelvic pain. Dyspareunia in 16 (55.2%), bloating in five (17.2%) and pelvic mass in thirteen (44.8%)  Unilateral pelvic mass in nine patients (31 %) and bilateral in four patients (13.8%). CA 125 levels are elevated in nine patients (31%) and significantly higher with endometriomas (76.1 ± 49.2 U/ml). 38% underwent robot assisted laparoscopic hysterectomy and BSO. 14.8% underwent robot assisted laparoscopic hysterectomy with Robot (LSO/RSO). Mean operative time 64.7 min. Mean blood loss 40 ml.

Conclusions Robotic surgery is safe, with minimal blood loss and shorter hospital stay. Alike in the surgical techniques, though diverse in the work infrastructure and technology, East and West have common scenarios which can be tackled with exchange of training opportunities. This interchange of knowledge and skills will benefit patients with increased surgeon’s efficiency.