At Chester County Hospital in West Chester, PA, many of the surgeries for the treatment of gynecologic cancers can be performed using minimally invasive techniques, reducing the scarring, blood loss and pain associated with traditional surgery. We also offer preventative surgery for women at high risk for developing cancer.
We are applying many of the latest technological advances to make minimally invasive surgery even better. We are one of the few institutions to provide Single Incision Laparoscopic Surgery.
Minimally Invasive Procedures
Minimally invasive surgical procedures avoid open invasive surgery in favor of closed or local surgery with less trauma. These procedures can often be done vaginally or involve use of laparoscopic instruments. Laparoscopy allows observation of the surgical field through an endoscope or similar device, and is carried out through small incisions in the skin to allow access into the pelvis or abdomen. This may result in shorter hospital stays, or allow outpatient treatment.
Minimally invasive surgery should have less operative trauma for the patient than an equivalent invasive procedure. Hospitalization time is shorter and the procedure causes less pain and scarring and reduces the incidence of post-surgical complications, such adhesions.
Laparoscopic Surgery and the Covidien SILS Procedure
What is Single Incision Laparoscopic Surgery (SILS)?
SILS is a revolutionary new way of performing laparoscopic surgery in which only one small (1.5 - 2 cm) incision is made to carry out an operation.
How is SILS different from traditional laparoscopic surgery?
Over the last decade laparoscopic surgery has replaced open surgery in the treatment of several diseases. In traditional laparoscopic surgery, the abdomen is filled with carbon dioxide gas to create a space for the surgeon to work in. Tubes called ports are then inserted through three to four small cuts, each measuring around 0.5 - 1 cm. A telescope attached to a camera inserted through one of the ports allows the surgical team to observe a magnified picture of the internal organs on a television screen. The surgeon carries out the surgery with the help of instruments introduced through the ports.
In SILS, the surgeon makes only one incision of around 1.5 cm - 2 cm (commonly just below the navel) to allow placement of three thin ports side by side. Else, a specially designed port (e.g. the SILS port) is inserted into the abdomen; this port carries the telescope as well as the laparoscopic instruments. The surgeon then carries out an operation identical to a traditional laparoscopic one.
How is SILS better for the patients?
As there is only one incision the patient experiences much less pain as compared to traditional laparoscopic surgery and recovers faster. The healed incision leaves practically no scar, thus making SILS cosmetically a superior option. All patients enjoy these benefits, but SILS is of particularly great cosmetic value to ladies (as most would prefer to have as few scars as possible) and to busy corporate executives who wish to recover rapidly from surgery so as to get back to work.
Can SILS be offered to all patients?
The surgeon would assess an individual patient to decide whether or not he / she are a suitable candidate for SILS. SILS may not be applicable to some patients. Those for whom it is not applicable are those who are very obese, those who have had multiple previous abdominal operations and or patients who are likely to have grossly enlarged or thickened diseased organ.
Traditional laparoscopic surgery, of course, can be offered to all these groups of patients.
What happens if an operation cannot be completed by SILS?
In a very few patients it may not be possible to complete the operation by SILS due to technical difficulties. The surgeon places one or two additional ports and completes the procedure in the traditional laparoscopic manner. Very rarely, it may be necessary to convert to an open operation. Both these issues are always discussed with patients prior to surgery and they are made aware that conversion to traditional laparoscopy or indeed to open surgery merely represents a sound judgment on part of the surgeon in the interest of patient safety.
Minimally Invasive Gynecologic Surgery and Robotic Surgery
With the use of the da Vinci Si Surgical System surgeons can perform advanced minimally invasive surgeries with the help of robotic arms. This provides an alternative to traditional open surgery and conventional laparoscopy, allowing even the most complex and delicate procedures to be completed through small incisions with unmatched precision and accuracy.
The latest in robotic technology, the da Vinci Si consists of four, thin robotic arms that are inserted into strategically placed small incisions (just one or two centimeters long). The surgeon operates from a seated console using hand and foot controls to maneuver the robotic arms. The console provides the surgeon with a 3-dimentional, high definition view of the surgical field - a better view than allowed with an open surgery. This new cutting edge technology truly replicates the experience of open surgery by preserving natural eye-hand-instrument alignment and intuitive instrumental control for the surgeon.