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Best of LI

December 6th, 2013

Robotic Surgery Provides Precision, Full Visualization for Improved Surgical Outcomes

Providers at Long Island Women’s Health Care Group, PC, use robotics to make gynecologic surgeries easier and safer for women.


Gary M. Levine, MD, FACOG, FACS, obstetrician and gynecologist at Long Island Women’s, illustrates the benefits of robot-assisted gynecologic surgery by describing a recent robotic hysterectomy he performed.

“The largest incision made during the surgery was about 3/4 of an inch,” he says. “People can return to work or their other normal activities in a third of the time it takes with non-robotic laparotomy. Because incisions are smaller, patients experience lower incidence of infection.”

Winthrop-University Hospital, where Dr. Levine and other Long Island Women’s providers perform surgeries, has a high-definition da Vinci Si Surgical System — which includes EndoWrist instrumentation and superior 3-D visualization. A dedicated team of operating room nurses and physicians assistants are specially trained in robot-assisted surgery, and the postanesthesia care unit team helps robotic surgery patients make the transition home quickly.

“Robotic surgery has replaced traditional laparotomy and traditional laparoscopy with techniques involving very small cameras and instruments the surgeon manipulates using a console,” Dr. Levine adds. “With this approach, surgeons can perform many traditional gynecologic surgeries, including hysterectomies, removal of cysts and certain cancer operations.”

Why the Robot?

Many benefits of robotic surgery, such as smaller incisions, have also been attributed to laparoscopic and minimally invasive surgery. In Dr. Levine’s perspective, robotic surgery takes these advantages to a new level.

“The beauty of the robot is it allows a surgeon to rotate the instrument on an axis of 360 degrees,” he says. “Surgeons can’t do this laparoscopically, and certainly not by hand. The hand can only rotate 180 degrees. As a surgeon, my dexterity is greater with the robotic instruments. Because the instruments and telescope are very narrow, I am able to access areas I cannot reach by hand and operate in much finer and smaller zones than with either laparoscopy or laparotomy.”

When it comes to patient experience, this finesse and comprehensive level of control allow for better results than other minimally invasive approaches, Dr. Levine says.

“In minimally invasive surgery, of course, you have less pain than in open surgery because the incision is smaller,” he notes. “However, even though the trocars and other instruments are similar to those used on robotic surgery, you are moving ports around more — left to right and superiorly to inferiorly — as well as constantly changing the camera position. When you use the robot, by contrast, the instruments spin in place and this results in much less pain to the patient.”

Dr. Levine, who has performed nearly 300 robotic surgeries, says the results are rewarding.

“One patient had a robotic hysterectomy on Monday morning and was on a plane to Florida on Friday,” he recalls. “If a woman needs gynecologic surgery, she and her provider should consider robotic surgery.”