Advancements in Robotic Gynecologic Surgery - Evelyn Felluca MD FACOG - Perfectly Female- Reston VA скачать в хорошем качестве

Advancements in Robotic Gynecologic Surgery - Evelyn Felluca MD FACOG - Perfectly Female- Reston VA

Board-Certified in Obstetrics & Gynecology, Dr. Evelyn Felluca has 30 years experience. https://perfectlyfemale.com/about-us/... She founded Perfectly Female Woman’s Health Care and has remained at the forefront of providing the latest in personalized, compassionate, quality care for women. Transcript: hi there i am brittany spalding i am part of the physician relations department here at Reston Hospital and today we have Dr. Evelyn Felluca with us thank you for joining us Dr. Felluca thank you for inviting me so Dr. Felluca is a board certified gynecologic surgeon she's been practicing in the northern virginia area for 30 years she started the robotics program in gynecology in 2009. she has had 10 years of experience with robotic surgery and performed approximately 1 000 cases using this advanced technology so today we are going to ask dr faluka a couple of questions and she is going to give us some great answers so Dr. Felluca let's start off i'm going to start by asking you why robotics well let me take you through the evolution of minimally invasive surgery when i trained in the late night 1980s to the 1900s hysterectomies were either a open large incision or they were vaginal hysterectomies laparoscopy was still in its infancy at that time laparoscopy i'll explain to you what that means entails doing surgery through very small incisions through the abdomen and then placing trocars these are considered trocars both of these um in those incisions and then placing the instruments in the incisions to perform the surgery so the first laparoscopic hysterectomy was performed in 1989 uh when i first saw this i was hooked i thought this is really wow this is great this is really i have to learn how to do this like a kid in a candy store however laparoscopy at that time was imagine going through this is the laparoscope looking through the viewpiece and looking in the incisions in the patient's abdomen and tilting it in a 45 degree angle can you imagine doing surgery for a long time in that position very uncomfortable over time they they um the innovators actually put the large camcorders in the 1980s and 1990s on their shoulders and then put them on poles so they could actually visualize the surgery and then ultimately and we still have these now cameras that are placed on the top of the laparoscopes so they can shoot the image on a live on a tv screen that's what we have in the operating rooms now so in 2005 robotics came along robotic assistant surgery was rep was approved for use in gynecology fantastic now let me ask you what is robotic assisted surgery so robotic assistant surgery is is not morning warning will robinson it's basically um laparoscopy on steroids okay it's taking conventional laparoscopy what we have here okay and moving it into taking laparoscopic surgery and basically uh changing it so that visualization precision everything is improved if i take you through that it's a win-win situation you're using the same trocars except the fact and you're putting the instruments in this is one of the instruments that's in there and it's very precise it's very delicate you can see that the tips are very fine they're very refined so the instruments are placed in the trunk bars the same as they were before except they're connected to the robotic arms so instead of being back and forth they're pivoting like this so there's less torque on the skin and less pain okay that's a start then the robotic system holds the robotic arm holds the camera board so it can operate with both hands once these instruments are placed in the in the abdomen through the incisions i move to the viewport of the console right next to the patient and i sit down i put my head in the view screen i have two cameras one each eye 3d high definition so i can see very clearly i move my hands which just like my hands outside the patient or inside the patient with the instruments and i can do all the precise unparalleled precision and manual dexterity moving the instruments inside the patient so my feet control the camera so i can see inside the patient and the other petals are for cutting or coagulating which is burning and then i can also sit comfortably which is great absolutely okay so if i can see better i can i can um be more comfortable certainly less fatigued and i have better precision i should be able to do better surgery right absolutely so for this reason robotics is a real game changer so why would you what other reasons would you say robotics is a big game changer um well back in the united states ultimately we performed 600 hysterectomies in the united states annually okay so remember the first laparoscopic surgery hysterectomy was performed in 1989. before 2003 over sixty percent of hysterectomies were performed open cut large incisions wow these are associated with more pain more blood loss