This article previously appeared in the Princeton Packet
Single site robotic hysterectomy in Princeton NJ
Dr. Bruce Pierce, the medical director of the robotic surgery program at Princeton HealthCare System, was the first doctor in the northeast to do a single-site robotic hysterectomy with the da Vinci Xi system robot. The surgery involved removing the uterus and both tubes and ovaries. This surgery is frequently done with a larger incision that is similar to that of a C-section. ”And that requires a two- to three-day hospital stay followed by a six-week recovery period,” Dr. Pierce said. “Since I do it minimally invasively with the robot, I’m able to make one tiny incision in the belly button and because of that, my patient goes home the same day. And basically in two weeks they’re back to work. They’re back to their normal routine.”
The benefits of robotic surgery
The value of robotic surgery is clear. ”Basically, it’s using technology to make a major surgery into a minimally invasive procedure, with the focus on quicker recovery,” Dr. Pierce said, adding that it involves less scarring. “Ninety percent of these surgeries can be done as outpatient.” Earlier this year, a large study was published in the “Journal of International Gynecology & Obstetrics,” with thousands of patients with a variety of hysterectomies. “They found in surgeons who were experienced with robotics, meaning they had more than 60 cases under their belt, they found the robotic hysterectomy has less complications, less need for re-operation, less need for readmission, and less bleeding and infection,” Dr. Pierce said. “The main thing was the surgeons needed to be experienced.” What makes a patient a good candidate for robotic surgery? “It depends on the surgeon’s level of experience,” Dr. Pierce said. He also said that it’s important to note that there is a learning curve with robotics.
The importance of using an experienced robotic surgeon
"It’s not perfect right out of the gate," he said. “With a beginning surgeon, you basically have to pick the easiest candidate, meaning somebody who is not overweight, somebody who has not had a lot of previous surgery, somebody whose uterus is small, a non-complex surgery. But the more experienced you get with the new technology, you’re able to expand the patient base to a more complex patient. So, all of a sudden these patients who used to be not candidates for robotics are now candidates with experienced robotics surgeons.” How will this technology develop? “The future though lies with more women becoming candidates and more complex cases being done in a minimally invasive manner,” Dr. Pierce said. What about the naysayers? “The detractors of robotics say it’s too expensive,” Dr. Pierce said, but he pointed out considerations as fewer hospital stays, and returning to a work a month earlier. Dr. Pierce has done hundreds of robotic surgeries for the past eight years. He has also taught other physicians how to do it for many years now. When considering robotic surgery, experience matters, he said, “I want to emphasize that an experienced surgeon is crucial to improved outcomes."