Bigger surgeries. Smaller incisions!

Assisting in a DaVinci Robotic hysterectomy in 2008 at University Hospitals Case Medical Center demonstrating a minimally invasive approach to surgery.

I just came back from Harvard’s Minimally Invasive Gynecologic Surgery conference held in Boston Oct. 15 to 18 under the supervision of Dr. Jon I. Einarsson. I have met Dr. Einarsson in 2003 In Houston, Texas during a minimally invasive surgery rotation with Dr. Robert Zurawin at Baylor. I was happily surprised to see Dr. Zurawin at the same meeting.

We are witnessing fast-paced advancements in technology that allows us to provide patients with the same benefits of surgery at lower risks, and faster recovery. These advancements are changing the field the way we know it and breaking traditional notions about surgery.

Surgery has traditionally been associated with a large scar, pain and lower mobility after surgery, a long recovery period and a longer time off work. This is changing.

Removal of the uterus (hysterectomy) is the second most common surgery in USA (The most common is Cesarean delivery). Hysterectomy should be done through the vagina whenever possible. In most cases, this is not possible due to the size or position of the uterus or due to lack of adequate training of the surgeon (at least in USA). Traditionally, the alternative was an abdominal hysterectomy (Through a large incision on the abdomen). In Canada they call it “Le grande opération”, French for “the big surgery”.

Peggy Turbett - (The Plain Dealer, 2008) Doctors at University Hospitals Case Medical Center perform a hysterectomy using a robotic device called the da Vinci Surgical System. While Dr. Vivian von Gruenigen works the robot's "arms" from a control booth (shown on the left), Dr. Hasan Abdessamad, right, assists with surgical instruments.

There is nothing big about a hysterectomy anymore when we can do it laparoscopically (through three small incisions). I send my patients home the next day and back to work a week later. They barely use any pain medicine at home.

In the Harvard conference there was much more muscle-flexing. Minimally Invasive Surgeons are now doing almost anything laparoscopically, even pelvic exenteration (or pelvic evisceration = a radical cancer surgery that removes all organs from a woman’s pelvic cavity). Robotic gynecologic surgery has picked up in USA and is starting to pick up in the more socialist Canada. It did not arrive to Lebanon as far as I know and according to DaVinci Surgery website.

I met the Da Vinci Robot in Houston in 2003 and was privileged to be trained on using it in Cleveland at University Hospitals – Case Medical Center.

With robotic surgery, the surgeon does not have to be scrubbed or even in the same room as the patient. Robotic surgery will allow surgeons to perform surgery remotely on people in war fields, in distant or under-served areas, or even in a space shuttle.

The DaVinci is not the only robotic system. The new generation of robots are lighter and smaller, making their use easier. They also have tactile feedback, so they feel just like the new generation video games.

Appreciating the Da Vinci robotic arms

It is only the begining.

Trying out the Da Vinci Console before we bought it - Cleveland 2008

Categories: Health

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11 replies

  1. very informative.thank you


  2. I had the opportunity to “play” with one at Hopkins and felt as though I was a child playing video games once again.

    I personally look forward to more remote surgeries where a facility can house the DaVinci device and be scheduled for a variety of surgical procedures based on which surgeon is operating it across the world.


  3. Hello, this is a really fascinating web blog and ive loved reading several of the articles and posts contained upon the site, sustain the great work and hope to read a lot more exciting articles in the time to come.


  4. Amazing how “minimally invasive” surgery takes up an entire room while the old fashioned way only took a few tools that could fit in one’s hand! Not saying it’s a bad thing, obviously, it’s just funny. 🙂


  5. There is no facility for training gynaecologists in Nigeria. My department is trying to set up one. Can you help out? Can I come to understudy how you organize your training and how you may also come over to train us?


  6. I mean training gynecologist in laparoscopic surgeries



  1. Advance your laparoscopic hysterectomy skills « Hasan Abdessamad
  2. Bringing Total Laparoscopic Hysterectomy to Northern New Brunswick | Dr. Hasan Abdessamad

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