Fibroids are benign tumors that commonly occur in or on the uterus, affecting up to 25 percent of reproductive-aged women. Some women don’t even realize they have fibroids because they never experience any symptoms. However, fibroids can cause menstrual pain, heavier periods, urinary problems, pain during sex and infertility for some women.
Maria Keanchong, M.D., a women’s robotic reproductive and gynecological surgery specialist at Hackensack University Medical Center, and her colleagues in the Department of Obstetrics & Gynecology, use advanced robotic technology to provide minimally invasive surgical treatment for fibroids — successfully relieving symptoms and restoring fertility.
Robotic Surgery for Fibroids
Fibroids originate from one muscle cell that begins to clone itself and are common in women of reproductive age. The production of reproductive hormones, such as estrogen and progesterone, causes fibroids to grow.
The spectrum of fibroid symptoms ranges from no symptoms to severe symptoms that impact daily activities and fertility. Symptoms vary depending on the size and location of the fibroids.
“When fibroids cause symptoms, we usually recommend oral contraceptives or an intrauterine device (IUD) that releases the hormone progestin as the first line of treatment,” said Dr. Keanchong. “If those treatments don’t resolve the symptoms, or if the fibroids affect fertility, surgery may be an option.”
Hackensack University Medical Center gynecologic surgeons perform myomectomies to remove fibroids using the state-of-the-art da Vinci robotic surgical system. Three of the system’s robotic arms hold small surgical instruments, and the fourth arm has a small video camera. The instruments and camera are inserted into the body through small incisions in the abdomen. The camera transmits a magnified 3D video image of the uterus onto a screen at the surgical console, where the surgeon sits and controls the robot.
“It’s a same-day surgical procedure, and patients experience less pain, a quicker return to normal activities, and less blood loss due to smaller incisions,” said Dr. Keanchong. “The precision of robotic surgery also helps to minimize trauma or injury to surrounding tissues, which is especially important when working near the reproductive tract.”
For women experiencing infertility caused by fibroids, Dr. Keanchong partners with infertility specialists to ensure that patients receive the treatment they need to improve their chances of conceiving a baby.
“We follow the gold standards of robotic surgery care for fibroids with outstanding results,” said Dr. Keanchong.
Expert Treatment for Other Reproductive Tract Conditions
Dr. Keanchong and colleague Jonathan Jimenez, D.O., also perform robotic surgical procedures to treat rare reproductive abnormalities. The team has treated conditions called Müllerian anomalies, including a duplicated uterus and pelvic kidney — which occurs when the kidney is located in the pelvis near the uterus, instead of in the back of the abdomen.
“Robotic surgical technology is beneficial during these surgical procedures because we are able to inject fluorescent dye and use the robotic surgical system’s near-infrared technology called Firefly to highlight the patient’s anatomy,” said Dr. Keanchong.
Dr. Keanchong said that because Firefly enables surgeons to identify the patient’s ureter, the tube that carries urine from the kidney to the bladder, and other important anatomical structures, it helps to lower the chances of accidental injury during surgery.
“This enhanced visualization enables us to perform a successful surgery and preserve the patient’s fertility while reducing the risk of complications,” said Dr. Keanchong.
Delivering Outstanding Fibroid Care
Dr. Keanchong said that Hackensack University Medical Center patients who have robotic surgery for fibroids and other conditions achieve fantastic — and sometimes even life-changing — outcomes.
“I’ve performed robotic myomectomies for women who were experiencing infertility due to fibroids and later I delivered their babies,” said Dr. Keanchong.