Gynecologic Surgery


Endometriosis is a condition that typically occurs in women during their childbearing years and results in the uterine lining, or endometrium, growing outside of the uterus. The tissue continues to respond to the regular hormonal cycle of the female body by building up and breaking down with each menstrual cycle. But because there is no place for the uterine lining to escape when it breaks down, the result can be inflammation and scars tissue around the affected areas. The scar tissue may result in blockages in the pelvic area and organs, in infertility or difficulty becoming pregnant. Endometriosis treatment consists of a variety of methods, including hormone therapy and surgeries. Surgery is used to remove uterine lining growing outside of the uterus in hopes that the patient may be able to bear children. In more serious cases, endometriosis treatment will require the uterus to be removed with a hysterectomy procedure. Endometriosis Symptoms The most common endometriosis symptoms are:

  • Abnormal or heavy menstrual flow
  • Cramps and menstrual pain
  • Infertility or difficulty becoming pregnant
  • Pain during sexual intercourse
  • Painful bowel movements during menstrual periods
  • Painful urination during menstrual periods
  • Pelvic pain

Uterine fibroids can cause symptoms that are similar to endometriosis Surgical Treatment Your surgical treatment options for endometriosis depends on your diagnosis and medical history, however in general there are two options:

  • Removal of endometrial tissue
  • Removal of reproductive organs (total or partial hysterectomy)

Robotic Surgery for Endometriosis The daVinci Surgical System is a robotic tool that provides surgeons with improved magnification and viewing of the surgical site, as well as greater precision and flexibility that can be helpful in surgery for endometriosis. Robotic-assisted surgery for endometriosis is promising for women who wish to preserve their uterus and would like to have children in the future. Regardless of the location of the endometriosis, surgeons use the daVinci robot to make small, precise incisions to remove the tissue and preserve the uterus. Robotic-assisted surgery is considered minimally invasive. This means that, instead of a traditional "open" surgery, there are several small incisions made in the abdomen. This is beneficial because the small incisions allow for a much shorter recovery time. With robotic-assisted surgery, you could see the following benefits:

  • Fewer complications
  • Less blood loss
  • Less pain
  • Less risk of infections
  • Less scarring

Robotic Hysterectomy

Hysterectomy is a surgical procedure that removes a woman's uterus and is the second most common surgery among women in the United States of America. In fact, one in three women in this country will have a hysterectomy before they reach 60 years of age. There are a number of reasons why your doctor may recommend a hysterectomy, including cancer, fibroids, endometriosis when other treatments have not helped, chronic pelvic pain or abnormal vaginal bleeding. Hysterectomies can be done through traditional abdominal surgery, through laparoscopic surgery or robotically with the da Vinci Surgical System. The majority of gynecologic conditions that can lead to hysterectomy can now be treated effectively without a big incision. With the da Vinci Surgical System, a hysterectomy requires only a few small incisions. The da Vinci system allows doctors to perform precise, minimally invasive hysterectomies that offer many potential benefits over traditional open surgery for most women, including:

  • Significantly less pain
  • Minimal blood loss and reduced need for transfusion
  • Fewer complications
  • Shorter hospital stays
  • Quicker recovery and return to normal activities
  • Small incisions for minimal scarring
  • Better outcomes and greater patient satisfaction

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

Robotic Myomectomy

Estimates are that uterine fibroids occur in up to one third of women in the United States. Uterine fibroids may grow as a single tumor or in clusters, and these nonmalignant tumors can contribute to infertility and miscarriages. New technology is making it easier to have uterine fibroids removed quickly and with smaller incisions. While not all women with fibroids experience symptoms, symptoms may include excessive menstrual bleeding, pelvic pain and infertility. If your doctor recommends surgical treatment for your fibroids, you may want to ask about a robotic Myomectomy procedure. Using the da Vinci Surgical System, surgeons can remove fibroids while preserving their patient's uterus. After removing each fibroid, surgeons carefully repair the uterus to minimize potential bleeding, infection and scarring. Robotic myomectomy may be more time consuming for the surgeon, but there may be many benefits for patients:

  • Shorter hospital stays
  • Less pain and scarring
  • Less risk of wound infection
  • Less blood loss and fewer transfusions
  • Quicker recoveries and return to normal activities

The GW Fibroid and Menstrual Disorder Center offers both diagnosis and treatment of fibroids including minimally invasive and robotic surgery.

Download PDF - Dr. Robinson

Watch Dr. James Robinson, Assitant Professor, OB/GYN speak about how robotic surgery is being used to treat female disorders.

Physician Profiles

Cherie Q. Marfori, MD, FACOG

Cherie Q. Marfori, MD, FACOG, specializes in minimally invasive gynecologic surgery (MIGS) and completed GW’s first post-graduate fellowship in MIGS under the tutelage of Dr. James Robinson. She...

Gaby Moawad, MD

Gaby Moawad, MD, is an Obstetrician Gynecologist and an Assistant Professor of Obstetrics and Gynecology. Dr. Moawad completed an American Association of Gynecologic Laparoscopists (AAGL)...

James K. Robinson, MD, MS

James K. Robinson, MD, MS is a board certified OB/GYN who performs minimally invasive laparoscopic and hysteroscopic gynecologic procedures including myomectomy, pelvic prolapse repair, excision...