A few days ago, I saw a local newspaper article that described a botched robotic surgery from 2009. The article went on to claim that new surgical technologies such as the da Vinci® Surgical System are not always properly evaluated by physicians and hospitals in terms of their potential harm to patients. Perhaps most alarming, the article noted that there are questions about the experience and expertise of many of the surgeons who use the equipment.
I always encourage my patients to be fully informed about the advantages and potential risks of any procedure they’re considering. From my perspective, the recent media coverage provides an excellent opportunity to explain robotic surgery and review what you can do to help prevent the kind of complications mentioned in the article. Finally, at the end of this blog you’ll find a description of my practice and what my patients can expect if they choose robotic surgery.
What is the da Vinci Surgical System?
As I explain on my website, the da Vinci Surgical System uses small incisions to allow surgical access for miniaturized surgical instruments and a high-definition 3D camera. Seated at a da Vinci console, the surgeon views a magnified, high-resolution 3D image of the surgical site. State-of-the-art computer technologies convert the surgeon’s hand movements into precise micro-movements of the da Vinci instruments. Introduced more than five years ago, the da Vinci Surgical System has been used successfully in tens of thousands of procedures.
As a minimally invasive technique, robotic surgery typically offers the benefits of less pain and bleeding, faster recovery and fewer potential complications compared to traditional “open” surgery. It also allows higher levels of precision and complexity than non-robotic laparoscopic procedures. However, as with any kind of surgical treatment, there are risks associated with robotic surgery. These risks include injury to tissues or organs; bleeding; infection, and internal scarring.
Questions for you to ask before you agree to robotic surgery:
If you’re considering any gynecologic surgery, including one that uses robotic technology, be sure to ask if your surgeon and his or her hospital are COEMIG-certified. COEMIG stands for “Center of Excellence in Minimally Invasive Gynecology.” According to the American Association of Gynecologic Laparoscopists (AAGL), which created the COEMIG program, COEMIG certification is only given to surgeons and facilities that uphold an “unparalleled commitment and ability to consistently deliver safe, effective, evidence-based care.” COEMIG standards are frequently upgraded as surgical processes improve. Certification is not merely a one-time achievement; it must be maintained. Designees are regularly monitored by a special medical review agency.
Experience with robotic and laparoscopic surgery?
If you’re considering gyn surgery, be sure that your surgeon is not only COMIEG-certified but highly experienced in laparoscopic and robotic surgery. Remember that a surgeon cannot safely go from “open” hysterectomy to complex robotic surgery overnight. So ask: How much experience does your surgeon and his or her hospital have with robotic surgery? How many years of experience and how many surgeries? Likewise, how much experience does the surgeon have with non-robotic laparoscopic surgery? What is the surgeon’s record of successes and complications from robotic surgeries?
Don’t be afraid to speak up and ask. These questions can help reduce surgical risks while providing reassurance that your provider and healthcare facility are committed to your health and safety.
About Dr. John Garofalo, M.D.
Dr. John Garofalo, M.D., is a gynecologist located in Fairfield County, Connecticut. Dr. Garofalo was the first gynecologist in lower Fairfield County to be certified on the da Vinci Surgical System more than four years ago. He has performed hundreds of procedures with the da Vinci Surgical System, with a complication rate of less than 1%. He also has more than 10 years of experience performing complex non-robotic laparoscopic surgeries.
Dr. Garofalo is certified to use the da Vinci Surgical System for diagnosis and/or treatments associated with the following conditions and procedures:
- uterine fibroids/myomectomy
- pelvic organ prolapse
About Garofalo OB/GYN & Associates
Dr. Garofalo’s practice, Garofalo OB/GYN & Associates, has been designated as a Center of Excellence in Minimally Invasive Gynecology (COEMIG) by the American Association of Gynecologic Laparoscopists (AAGL). According to the Surgical Review Corporation (SRC), which administers the program on behalf of AAGL, more than 650 providers around the world currently participate in the COEMIG program, which was launched in 2010.
For more information on Dr. Garofalo and his medical practice, go to www.garofaloobgyn.com. Dr. Garofalo can be reached for a personal consultation at 203.855.3535.