Robotic Hysterectomy, an Interview with Dr. Gigi Streiff, MD

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Discussion of the DaVinci Hysterectomy (also known as Robotic Hysterectomy).

Dr. Streiff is an expert OBGYN who has been in practice for over 29 years in St. Louis. She has received specialized training in a type of hysterectomy called a robotic hysterectomy. Today she will discuss with Dr. Kathy Maupin, an anti-aging doctor who functioned for 30 years as an OBGYN in St. Louis. Both women have been in the forefront of medicine as it concerns treating women and between them have performed thousands of procedures, treatments, and hysterectomies. Dr. Maupin has recently produced a podcast discussing various types of hysterectomy, one of which is the Robotic type. Because this is not her area of expertise, Dr. Maupin reached out to her friend and colleague, Dr. Streiff, who is expert in this procedure for information to share with you.

Dr. Strieff will tell us what a DaVinci or Robotic hysterectomy is and how it differs from other types of such operations. She says that the FDA authorized robotic surgeries for gynecologists and cardiac surgeons in 2005. Such surgeries require specialized instruments and special training for the physician. She will also explain that if you need a hysterectomy and are considering having it done robotically, you can find a surgeon trained in this procedure on the DaVinci website. You and your doctor might consider such a type of hysterectomy if you suffer from severe endometriosis, cancer, or uterine and bladder prolapse.   The Davinci hysterectomy, also called a robotic hysterectomy, removes the uterus with or without the tubes and ovaries through a number of very small incisions using laparoscopes and tiny instruments that are able to do delicate surgery without causing adhesions or damage to other organs.

All hysterectomies are done under anesthesia; however, a normal abdominal or vaginal hysterectomy is done through an abdominal or vaginal incision. The surgeon uses her hands to clamp, cut and tie vessels, and the ligaments and tissues that connect the uterus and ovaries to the pelvis.   Robotic surgeries are much more complex, and your gynecologist must be specially trained to use special instruments and the robot to do the clamping cutting and tying.

In the robotic surgery, cameras are placed in the abdomen with lights that allow the surgeon to see what they are doing. No large incisions are made.  Robotic surgery requires a lot of manual dexterity on the part of the doctor. As this type of surgery takes place, there is a team of people (nurses, several surgical assistants, the surgeon and the anesthesiologist to provide this complex surgery. All of this team and the robot maneuvers around the woman’s body to achieve the proper angles to operate.  The doctor uses a console providing a three-dimensional image and operates the tiny micro tools to provide the laparoscopic robotic surgery to remove the womb and or ovaries, and sometimes to elevate the bladder and or vagina if there is prolapse. The robot is synchronized with the tiny little drivers inside the gloves that operate the robot so that the surgery can even be done at a long distance for patients in remote parts of the world.

Robotic surgery isn’t ideal for everyone. Robotic surgery takes longer, the patient is under anesthesia longer, and the cost is higher because of the personnel needed.  This type of surgery is ideal for patients with a lot of adhesions that block the view in normal surgery or for surgery where the bowel and or bladder are stuck to the uterus and ovaries like in endometriosis.

In order to be trained, the doctors who do robotic surgery are sent to specialized labs where the instruments (including the robot) are located and practice the surgeries on fetal pigs. This is a humane treatment of the animal, but it helps the doctor to move slowly and precisely so that when they operate on a human being, they have the skills and knowledge that is important to successfully operate on a human patient.

This training is just like all medical training, a doctor learns by studying, by watching, then by helping or assisting more experienced doctors, and then, finally by doing it themselves. It is complex and requires additional medical and technological knowledge as well as a lot of practice. Doctors are only certified after they operate on patients under the supervision of a proctor who is an expert in the field. That way, the patient is safe.

You will hear these two doctors talk about the different procedures they have performed on female patients with specific health issues. It is interesting and informative, and you will learn what you need to know in order to discuss with your own doctor what your treatment needs are. After all, an informed consumer is the best consumer. This will lead to better medical outcomes for you.


This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

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