Robot-assisted bilateral salpingo-oophorectomy (the surgical removal of both ovaries and fallopian tubes) is frequently performed to decrease the overall pain associated with endometriosis—the abnormal growth of endometrial cells outside the uterus. In this case, the procedure is usually done in conjunction with a radical resection of endometriosis as well as a hysterectomy. Because robotic surgery combines the trauma-sparing benefits of a minimally-invasive procedure with superb 3-D, high-definition visualization and highly precise, computer-guided surgical capabilities, it can offer gynecologic surgeons a number of advantages—including the ability to remove abnormal tissue with great accuracy and, in some cases, work faster.
If the patient’s endometriosis is limited to just one ovary, it may be possible to perform a unilateral salpingo-oophorectomy, in which only the diseased ovary and fallopian tube are removed. This preserves the patient’s ability to become pregnant using eggs from her remaining ovary.
In this procedure, four standard ports are placed in the patient’s abdomen using quarter-inch incisions, and the robot’s camera and instrument arms are inserted through the ports. Next, the surgeon locates the ovaries and the blood vessels that supply the ovaries, and also identifies the ureters (the tubes that carry urine to the bladder). The surgeon then uses the robot’s instrument arms to detach the ovaries and fallopian tubes from their blood supply and from their attachment to the uterus.
Less scarring. When salpingo-oophorectomy is performed robotically, the dime-size incisions result in significantly less scarring than with an open procedure.
Less post-operative pain. The smaller incisions used in robotic salpingo-oophorectomy also result in less post-operative pain than the large abdominal incision employed in open surgery. In addition, there may be less manipulation of the incision sites when using the da Vinci Si surgical system compared to laparoscopic surgery. This may also contribute to decreased post-operative pain—something that is the subject of an ongoing prospective investigation by the gynecologic surgeons at NYU Langone’s Robotic Surgery Center.
Faster recovery and shorter hospital stay. Most patients undergoing robotic salpingo-oophorectomy are able to resume normal activities within 2 to 3 weeks, compared to 6 to 8 weeks for open surgery.
Superior visualization of the operating site. The magnified 3-D, high-definition image provided by the da Vinci Si surgical system enables excellent visualization of the ureters, blood vessels, and ovaries during surgery.
Our surgical program for the management of benign gynecologic conditions is spearheaded by Dr. Kenneth Levey, who specializes in the surgical treatment of fibroid tumors, endometriosis, abnormal uterine bleeding, and chronic pelvic pain. Dr. Levey is one of New York’s most experienced surgeons at both robotic and laparoscopic minimally-invasive gynecological procedures, and has used the da Vinci Si surgical robot to perform numerous robotic salpingo-oophorectomies to relieve endometriosis-related pain.