Excision of Endometriosis- Robotic Advantage

Endometriosis is a chronic and progressive gynecologic disorder that affects more than 70 million women and adolescents worldwide. This disease tends to affect them through out their life. Chronic pain and infertility are the most debilitating problems associated with endometriosis. Laparoscopy is considered the gold standard for diagnosis,as there are no blood tests at present that can confirm endometriosis. Laparoscopic surgery is also the standard method to treat the disease when conservative therapy fails. Laparoscopic surgery today has replaced laparotomy for the treatment of endometriosis for the obvious advantages. However due to technical limitations in laparoscopic surgery not every surgeon is able to give adequate and satisfactory outcome in cases of endometriosis which leads to persistence of problems like infertility or pain as well as recurrence of disease. Due to this inadequacy in endometriosis management, Robotic assisted surgery can be a game changer in women's health care. Surgeons should do surgery for endometriosis with experience in the field and at centers where all infrastructures is available.

Endometriosis is a slow and progressive disease, takes years to develop lesions that can be picked up by traditional methods of diagnosis like USG or MRI. By the time these women require surgical therapy for overt clinical symptoms like dysmenorrhea, chronic non cyclical pelvic pain, subfertility, heavy menstrual bleeding or abdominal gaseous bloating, they would be having advanced stage disease.

Removal of all visible endometriosis by traditional laparoscopic surgery is not possible at all centers and thus robotic surgery is increasingly being used for the same. Many centers and surgeons now feel that robotic assisted surgery is probably the most suited for endometriosis management.Robotic surgery with 10 times magnification and wristed movements of the instruments helps to achieve this.

Therapeutic surgeries in advanced stages of endometriosis require skill and proper equipment to restore pelvic anatomy and function. Robotic surgery with all its advantages has the ability to perform complex resections, including endometriosis affecting bladder and bowel.

Our unit at Apollo Hospital, Hyderabad has experience of over 4 years in managing advanced stage endometriosis with Robotic surgery.

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