Too often, with medical conditions that are not life threatening, women choose to simply “live with it”—whatever “it” may be: sore knees, chronic headaches and even highly disruptive conditions such as urinary incontinence and pelvic organ prolapse. In the matter of the last two, women in the Philadelphia area no longer need to grin and bear it.
At the North Wales office of the Institute for Female Pelvic Medicine & Reconstructive Surgery, Nina Bhatia, M.D., and Miles Murphy, M.D., M.S.P.H., F.A.C.O.G., treat women who struggle with pelvic organ prolapse, as well as urinary incontinence and other conditions that rob women of their quality of life.
Pelvic organ prolapse is characterized by a portion of the vaginal canal protruding from a woman’s body. The condition often occurs after the pelvic floor collapses as a result of childbirth (although the condition may not present until after menopause). For many women, a pelvic prolapse surgery, known as sacrocolpopexy, may be the best treatment option to the condition. In this procedure, a surgical graft is used to hold the affected pelvic organs in the correct anatomical position to provide long-term support.
Traditionally, this type of prolapse surgery had been performed as an open surgery, with a long horizontal incision in the lower abdomen to access the pelvic organs. Recovery was often a painful and lengthy process. Advancements in technology have enabled qualified surgeons to perform prolapse surgery in minimally invasively fashion—through small incisions made laparoscopically.
However, traditional laparoscopy may present challenges for some candidates, too, due to the rigidity of instruments needed to perform the procedure. Fortunately, there is a second minimally invasive option that overcomes the limits of traditional open and laparoscopic surgery: the da Vinci Surgical System.
The da Vinci System is a state-of-the-art robotic surgical platform with three-dimensional, high-definition vision and miniaturized, wristed instruments designed to help doctors exceed the limits of the human hand. The doctor controls the da Vinci system, which translates hand movements into more precise movements of miniaturized instruments inside the body. The system is improving the experience of surgery for women around the world.
“Prolapse can be a very devastating disease because it prevents women from engaging in activities with friends and otherwise living life to the fullest,” says Dr. Bhatia. “Essentially we’re offering the ability to have this problem of prolapse taken away so they can return to normal activities with fewer limitations.”
The Institute for Female Pelvic Medicine & Reconstructive Surgery uses the da Vinci system predominantly for sacrocolpopexy, though it can also be used for a myomectomy, or the surgical removal of uterine fibroids, according to Dr. Bhatia.
“We utilize it mostly in people who have severe prolapse or recurrent prolapse, and it is also particularly good in sexually active patients,” says Dr. Murphy. “I would say maybe a quarter of our patients go this route [with da Vinci surgery].
“In a certain way the da Vinci makes it much easier because the instrumentation gives you [the doctor] much more freedom and makes things like suturing easier,” he continues. “It’s easier because you’re not touching the patient based on feeling alone; it also gives you visual clues that are superior compared to someone who is using traditional instruments alone.”
Performing a sacrocolpopexy using the da Vinci system offers several potential benefits over open surgery—namely, tiny incisions to diminish scarring, minimal blood loss, shorter hospital stays and briefer operations. In addition to these benefits, there’s a lesser chance of developing a postoperative hernia, according to Dr. Murphy.
He recalls one patient in her 30s who was burdened by utero-vaginal prolapse and very self-conscious about her condition. Since having the procedure performed to repair the condition, the patient’s life has changed dramatically.
“Now, one year after the surgery, it has really changed her life,” he says. “Sexuality is very important to many women, and prolapse can really disrupt that. [Prolapse surgery] made someone who had been embarrassed to have intercourse, to have a normal sexual relationship with her husband, all with just one overnight stay.”
Doctors who perform sacrocolpopexy must undergo specialized surgical training that comes with a three-year fellowship in pelvic reconstructive surgery. Using the da Vinci system requires even more advanced training. For his part, Dr. Murphy has already performed more than 100 surgeries using the da Vinci system, while Dr. Bhatia will have her certification using the system by the end of the calendar year.
“This is a great minimally invasive approach to prolapse repair, but there are other minimally invasive approaches, and we are fortunate enough to be well trained in all approaches to reconstructive surgery,” says Dr. Murphy. “The vast majority of our patients suffer from incontinence or pelvic organ prolapse, and we work with all our patients to carefully determine the best option for them.”
The Institute for Female Pelvic Medicine & Reconstructive Surgery
1010 Horsham Road
North Wales, PA 19454
Web: www.fpminstitute.com
Phone: 215-855-4713
