The Women’s Medical Center at Brookwood Baptist became a pioneer in women’s healthcare in Alabama in 1988 when they opened the first women’s hospital in the state. They have done it once again by becoming one of the first hospitals in Alabama to perform gynecological robotic surgeries.
Robotic surgery is a type of surgery that is minimally invasive, which means that small, surgical robotic instruments are used to operate on a patient via small incisions instead of the traditional open surgery requiring large incisions. Robotic surgeries also allow doctors to perform surgeries with more flexibility and dexterity than traditional surgery. Brookwood began the process of adding robotic surgeries to its offerings more than 10 years ago. “Dr. Greg Banks and a former colleague of his began educating us about where women’s surgery was progressing in regards to noninvasive surgery,” says Brookwood Baptist Health Chief Nursing Officer, Amy Beard. “Our women’s physician group certainly embraced the concept. They were definitely forward-thinking with regard to the latest and greatest technology in women’s surgery for benign gynecology cases.”
Robotic surgeries for a variety of gynecology issues officially began at Brookwood in March 2009, specifically with the da Vinci Robotic Surgical System by Intuitive Surgical. The da Vinci system allows surgeons to perform surgery with a 3D HD view inside the patient’s body with wristed instruments that bend and rotate much more than a human hand. One of the instruments is a laparoscope, a thin tube with a tiny camera and light at the end, which sends images to a video monitor in the operating room for the surgeon to see. The system had long been used with other types of surgeries, such as prostate surgery, cardiovascular surgery, urologic surgery and oncology surgery. Brookwood’s physicians saw the potential in utilizing the technology for gynecology. “Robotic surgery allows you to perform really advanced laparoscopic surgeries with much smaller incisions,” adds Dr. Banks, who has performed more than 800 robotic surgeries (as of third quarter 2018) at Brookwood and is one of the top robotic surgeons at the hospital. “It’s very tedious in how the instrumentation works. You can magnify it and see small areas, which gives us a lot more dexterity with the instrumentation. It gives us the ability to convert cases that would typically have been large open surgeries into robotic cases.”
Common gynecology issues requiring surgery that are now performed robotically at Brookwood are hysterectomies, fibroids, removal of enlarged ovaries, endometriosis and fertility reconstruction, as well as oncology surgeries like endometrial cancer, cervical cancer and ovarian cancer. It allows doctors to do so with just three or four one-inch incisions near the belly button rather than the typical open surgery incision that’s approximately 12 inches long. “In addition to better visualization, we get a range of motion with the robotic approach,” says Dr. Mack Barnes, who has performed nearly 850 robotic surgeries (as of third quarter 2018) at Brookwood, making him the top robotic gynecology surgeon. “We get a full range of motion. It’s almost like we’re operating with our fingerprints. There is so much better precision and less blood loss. It allows us to perform more complex procedures.”
Robotic gynecological surgeries also allow for many other benefits for the patient. The smaller incision typically means fewer complications, decreased risk of infection, decreased risk of bleeding and blood clots and less overall time in the hospital. In fact, many hysterectomy patients get to go home the very same day instead of staying the traditional three or four days in the hospital when having an open procedure. “Patients can quickly get back to functioning well,” says Dr. Banks. “Patients can be back to work much more quickly. For example, with traditional open surgery for a hysterectomy patient, it would take six weeks or more to get back to work. With robotic surgery, I’ve had patients get back to work as quickly as a week. Downtime after robotic surgery is much less.”
This state-of-the-art robotic technology has allowed doctors to convert so many gynecological surgeries from traditional open procedures to streamlined robotic surgeries that it has completely changed the surgical landscape at the hospital. In fact, as Dr. Barnes shares, 10 years ago, only about half of the gynecological procedures were performed in a less invasive way, with the other half performed through an abdominal incision. “Now, approximately 85 to 90 percent of hysterectomies are performed in a minimally invasive way,” Dr. Barnes says. “That’s predominantly due to the robotic approach.”
Dr. Barnes also notes that 10 years ago, 80 to 90 percent of endometrial cancer surgeries, the most common type of surgery he performs, was performed with a large abdominal incision and dominated by the higher risk of infection and deep vein thrombosis (DVT). “More than 90 percent of those cases are now performed robotically,” he says. “Beyond that, complex procedures like severe endometriosis and cervical cancer were done about 90 percent of the time via open incision. Now, the majority are done robotically.”
Currently, Brookwood has 30 robotically trained gynecology surgeons. In total, just over 7,100 robotic gynecological surgeries have been performed at the hospital since 2009. Now celebrating a decade in, the hospital’s administration is looking to continue being at the forefront of women’s healthcare. “Our women’s hospital has been a differentiator for women’s healthcare consumers,” says CNO Amy Beard. “We offer a comprehensive program that has always stayed cutting-edge but is also focused on the female consumer experience. The gynecological robotic surgery program aligns with the vision that has remained in place since the women’s hospital began, and that is that Brookwood will be a market leader in providing the most evidence-based technologies and healthcare for women.”