Posted by Brigham and Women's Hospital March 2, 2012
Technological innovation can be intoxicating. We’re fascinated by the ability to do something that we’ve never done before – to start a faucet without touching a handle, to take a picture without using film, or to accumulate hundreds of friends without the hassle of talking to them.
But it’s a whole new ballgame when new technology becomes a part of the health care decision-making process. We’re no longer talking about matters of enhanced convenience or new forms of amusement. We’re talking about our bodies, our minds, and perhaps our mortality, and, thus, our fascination becomes tempered by uncertainty. We’re enticed by the potential advantages that a new technology can bring, but we’re also comforted by the reliability of medical practices that are tried and true.
Dr. Antonio Gargiulo and Dr. Serene Srouji, who perform robotic reproductive surgery, are quite familiar with this quandary. Patients come into their office excited about the advertised benefits of robotic surgery – less scarring, less blood loss, improved fertility – but also a bit scared about the prospect of being operated on by a surgeon who is guiding robotic arms fitted with surgical instruments. They question whether it’s safe, whether it’s really better.
When asked about the viability of robotic surgery, Dr. Gargiulo isn’t reserved in his response. “In ten years, most myomectomies (surgical removal of benign uterine tumors) will be done robotically,” he proclaimed. “It’s the new face of reproductive surgery.”
He is also very open about telling patients that robotic surgery is a relatively new technique and that there isn’t a preponderance of data to back up its advertised benefits – yet. However, his personal experience with robotic surgery isn’t merely anecdotal. He and his surgical partner, Dr. Serene Srouji, have collectively performed over 600 major robotic gynecologic procedures at Brigham and Women’s Hospital and Faulkner Hospital since 2007, and none of these procedures have resulted in the loss of uterine function or the need for more invasive interventions.
But, as reproductive surgeons, a quick recovery and the preservation of uterine function isn’t enough – significant, but not enough. Their ultimate goal is to improve their patients’ fertility, and they are convinced that the precision afforded by the robotic surgical system enhances the ability to achieve that goal. This conviction is supported by newly published scientific data from their team that reveals a compelling absence of scarring around the reproductive organs among women who have had a robotic myomectomy, as compared to women who have undergone an open myomectomy or a non-robotic laparoscopic myomectomy. This is significant, as this type of scarring can cause infertility and increases surgical risks during a cesarean delivery.
Dr. Gargiulo recently told us about one of his patients, Sophia Watson, who was unable to get pregnant before coming to him to have her uterine fibroid (tumor) removed robotically. After her surgery, she and her husband conceived on their first try and also had no trouble conceiving their second child.
Seeing those happy patients, those healthy babies – that’s why he believes in the future of robotic surgery.
– Chris P.