Laparascopic vs Robotic vs Abdominal Surgery

woodstock99

Hi everyone.  While my surgeon told me she may have to do open surgery she has me book for the below HOWEVER after doing a lot of research over the weekend I do not want robotic surgery for a number of reasons. I am concerned abourt my age, the position they have to put you in and issues that i alreday have with my eye pressure (wet amcular degeneration and being watched for glaucoma), longer surgery, position of anestiologist if there is an issue in surgery, etc.I did not know that this would be a longer surgery.  I know there are benefits on the other side - shorther hospital stay and easier/quciker recovery but for me I am not sure they outweigh greater long term risks.  Am I able to tell my surgeron I do not wnat robiotic surgery?   Also is laprascopic different than robitic or are they the same?  Sorry I am getting closer to surgery on June 10th and starting to freak out more.  Thanks.     

HYSTERECTOMY, ROBOT-ASSISTED, LAPAROSCOPIC, USING DA VINCI XI, WITH BILATERAL SALPINGO-OOPHORECTOMY

oldbeauty

Of course you are allowed to voice your concerns!

Welcome, Woodstock99.  I don't see why you cannot express a preference; however, it may be useful to get your opthamologist involved to express a medical opinion.  If that specialist doesn't see a problem, you can reassess or simply tell your surgeon that you want an open surgery.  I believe that is called a "laparotomy," and that anything with "-scopic" in it is meant to convey a less invasive operation.  There were studies published in the last two years that concluded that robotic did not offer any greater benefit overall.  However, I suspect that the younger generation of surgeons is probably more experienced in robotic than open.  You might want to ask your doctor what her surgical history/experience is, to settle your mind.  I had an open surgery (never given a choice) and recovered very easily.  But I think the type of incision is important, though.  The ob/gyn who did my hysterectomy chose an incision that prevented me from getting sentinel node dissection.

Best wishes to you as you approach this surgery; it is important to get settled in your mind what is going to happen and have confidence in your practitioner.  Oldbeauty

MAbound

Open surgery

There are always going to be pros and cons to any of the different surgical techniques. I agree with Old Beauty about getting your eye doctor involved in the decision and talking to your surgeon for you if he has concerns.

As far as open abdomen surgery goes, that's what I had, with the incision from pubis to navel, and it is no picnic to recover from. I don't understand why you think the robotic takes longer. I'm glad that is what I had because my uterus was enlarged from the cancer and I turned out to be at an advanced stage, so I could have gone in expecting a robotic procedure only to end up with the abdominal. My surgery went longer than expected because apparently my uterus was really well-anchored and exceptionally difficult to remove. The moral of my experience is that no matter what technique is used, there is always the potential for something unexpected once the surgery is underway. The surgeon needs you to let him use his judgement and expertise if something comes up. If you are looking for guarantees for what's the safest course, that just isn't possible and so getting your eye doctor to address your concerns with your surgeon seems the best way to cover your bases and perhaps go into surgery with a bit easier frame of mind.

Whatever type of surgery you ultimately end up having, remember to get up walking the next day and thereafeter; no matter what. It helps with the gas pains after robotic surgery and helps prevent the complication of Ileus if you have the open abdomen. Ileus is where the bowel fails to start moving again after the paralytic that's part of the anasthesia they use to keep intestines from moving during the surgery. I developed that after my surgery from lack of help dealing with all of the paraphernalia  tying me down (2  IVs, foley catheter, drainage tube, mechanical compression stockings) to the bed and it was miserable and prolonged my hospital stay. 

 

I'm glad you are doing a lot of reading to both inform and advocate for yourself. Being prepared for recovery after your surgery will be very helpful and should make it easier for you. It's never fun, but it's doable. Hang in there!

Primavera

Laparoscopic vs robotic

I think in laparoscopic, the surgeon makes tiny incisions and inserts camera and small instruments and operates using those (with his own hands).

In robotic, the surgeon will direct a robot from a console to operate. It's supposed to be more exact than laparoscopic because a robot's instruments can rotate a full 360 degrees and are more flexible than a surgeon's hands/wrist. 

I don't know what I had of the two, but I did see the big machine/robot on my left side before I fell asleep. It was a bit scary to see.

I don't think any of these two take longer than the open surgery, but I might be wrong. My scans had told my oncologist/surgeon that the uterus was small and that there were no other masses anywhere else that they could see, so laparoscopic and robotic were the main choices.

I agree you should voice your concerns about your eyes and involve your eye doctor. Technology and science advance every year and we should take advantage of it as much as we can.

woodstock99

For those who did robitic,

For those who did robitic, are any of you over 65 if you don;t mind my asking?  Thanks.  

els19

Robotic surgery

I was 63 when I had robotic surgery after I was found to have UPSC. I was in the hospital overnight and went home the next day. I had  small scars on my abdomen and my recovery was very fast. I had laparoscopic surgery a few years before that to remove my gallbladder and that was a fast recovery too. I have small scars from it too. My husband jokes I look like I was in a knife fight with my small scars from both surgeries. A friend had open surgery because of her ovarian cancer and her recovery was a lot longer than mine. Checking with your eye doctor is a good suggestion. I was very happy I had robotic surgery. 

MoeKay

Study on Robotic Surgery in the Elderly

I know you've been doing research on the robotic surgery issue, so you may have already seen this recent study published in the Annals of Surgical Oncology  Here's the link to the journal article:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639802. 

Is Robotic-Assisted Surgery Safe in the Elderly Population? An Analysis of Gynecologic Procedures in Patients ≥ 65 Years Old

I didn't read the entire article, but here's what the study concluded:

Conclusions.

Robotic-assisted surgery appears to be safe in an elderly cohort. The incidence of overall and major complications is consistent with those reported in the literature. Patients ≥ 85 years old appear to be at higher risk of unfavorable outcomes.

I would discuss your concerns with your gynecologic oncologist and hopefully she will be able to address any lingering issues you have about your upcoming surgery.

Wishing you the best on the 10th!

 

Primavera

woodstock99 said:

For those who did robitic,

For those who did robitic, are any of you over 65 if you don;t mind my asking?  Thanks.  

Age

57 when I had my surgery, two years ago.

thatblondegirl

I was 65

when I had my robotic, laproscopic, vaginal total hysterectomy. I have no co-morbidities to complicate anything. Surgery was less than an hour, I was in recovery for a few hours, and then went home. Easy recovery.

The women here know...you can read my "About Me" page...that I let a regular GYN do my surgery and he was so sure there was no cancer that he was in and out in a jiffy and left behind 4 small, bright, neon orange cancerous tumors. So, then I needed a second staging & tumor debulking surgery. Fun. Fun.
As I recall, you already are in the hands of a GYN/ONC, so that's good! I think you'll do fine!

Hugs, Alicia

BluebirdOne

I was 67, almost 68 and had robotic, in 2018

No real issues post surgery. I also had my surgery at Mayo, Rochester, and I would expect that if it were not a safe procedure they would not have used it. I can only speak for myself, but after having two C-sections with a much younger body, I was so happy that this was offered to me because abdominal surgery takes a while to recover from. They did warn me that I might have to have open surgery if things were not right for the robotic approach. Any surgery is a major event so it is normal to be concerned and try to ease your mind at their approach. Ask questions until you are satisfied with the answers. Good luck to you!

Denise 

woodstock99

Tnaks everyone.  After

Tnaks everyone.  After speaking to my opthamologist and retiuan specialist and doing more research on the benefits of the robotic surgery I will allow my surgero to do this if that is what she feels is best for me.  Of course she said if she finds lot sof scar tissue or other issue she may need to pivot to open but she stressedto me this now the standard of acre and I need to trust her.  Kind od scary though nonetheless.