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Excision of Endometriosis Hysterectomy Myomectomy Ovarian Cystectomy

Iris Kerin Orbuch, M.D. | Advanced Robotic & Laparoscopic Surgery

Gynecology Surgical Solutions

Conditions Dr. Orbuch Treats

Excision of Endometriosis
Myomectomy
Hysterectomy
Ovarian Cystectomy

Excision of Endometriosis

The da Vinci system with its 3-D High Definition Camera allows for precise excision of endometriosis. Excision of endometriosis is the gold standard treatment for endometriosis. Ideally all endometrial lesions should be excised. Unfortunately most gynecologists are not trained in advanced endometriosis cases. Others approach endometriosis with cautery or a laser, two modalities shown to be far inferior to excision using scissors, the method performed by Dr. Orbuch. With scissors, the endometrial implants are removed, but with cautery or a laser the lesion remains and continues to cause pain necessitating more surgery. A doctor utilizing laser may vaporize the surface of the lesion, but still leaves active endometrial tissue below. Deep fibrotic endometriosis usually does not respond well to hormonal suppressive therapy. Adequate surgical excision of endometrial implants provides the best symptomatic relief and long term results. In addition, surgical excision has been shown to improve fertility rates in women. Drug therapy can suppress endometriosis, not eradicate endometriosis. The definitive treatment of endometriosis is NOT hysterectomy or removal of both ovaries; rather it is complete excision of endometrial lesions.

Excisional surgery makes sense if one understands what endometriosis is. Normally during a monthly cycle, a woman's' endometrium, or uterine lining builds up then is shed as her monthly flow of menses. The endometriosis areas growing outside the uterus go through a similar cycle but because the build up cannot leave the body, the implants get deeper and deeper. Additionally, endometriosis lesions can irritate nearby tissue causing adhesions, scarring, and pain. Over time, endometriosis can grow into nodules causing scaring to nearby organs. Excision of endometriosis is the only therapy to objectively cure disease and thus improve quality of life. Dr. Orbuch excises endometriosis using Wolf blunt scissors, a technique initially performed by Harry Reich, M.D., a leader in advanced gynecological endoscopic surgery. This technique, along with other advanced laparoscopic techniques, was learned during her advanced laparoscopic fellowship with Dr. Harry Reich and Dr. C.Y. Liu.

More endometriosis resources
The Endometriosis Association
Endometriosis.org

da Vinci Hysterectomy

Dr. Orbuch performs da Vinci Hysterectomy for many benign (non-cancerous) conditions such as heavy bleeding, fibroids, pelvic prolapse, or adenomyosis. The da Vinci System enables Dr. Orbuch to perform a minimally invasive hysterectomy even for complex conditions with enhanced vision, precision, dexterity and control. Using state of the art technology, a da Vinci Hysterectomy requires only a few incisions so you can get back to your life faster. With traditional open surgery, recovery time is often 6-8 weeks with patients' remaining in the hospital for 2-3 days. In contrast, after a robotic hysterectomy, a patient only stays in the hospital overnight and can expect a 2 week recovery. An interesting fact is that one in three women in the U.S. will have a hysterectomy before she turns 60. If your doctor recommends a hysterectomy to treat your condition, you may be a candidate for da Vinci Surgery. In addition, da Vinci hysterectomy offers women many potential benefits over traditional surgery, including:

da Vinci Myomectomy

Uterine Fibroids are benign tumors normally occurring in about 30% of women. They grow in the uterine muscle (intramural myomas), on the outside of the uterus (subserosal myomas), or in the uterine lining (submucosal myomas). Some women are asymptomatic while others experience heavy bleeding, pain, frequent urination, or infertility.

The da Vinci robot enables precise dissection of fibroids using the endowrist instruments. The robots' wrist can turn nearly 360 degrees, allowing great flexibility. In addition, this helps to access fibroids in difficult anatomic locations. Because the da Vinci robot allows Dr. Orbuch to view the fibroid and uterus in a magnified 3-D view, very small blood vessels can be seen to minimize blood loss. The robot also eliminates any tremor in a surgeon's hands, and for delicate work, "motion scaling" software reduces a surgeon's actual hand movements to much smaller, finer instrument movements.

The da Vinci robotic myomectomy is providing women an opportunity to retain their uterus and subsequently, retain their fertility. Laparoscopic myomectomies often take longer than open abdominal myomectomies, and many are converted during surgery to an open abdominal incision if the fibroids are too large and/or there are many fibroids.

Robotic myomectomies are performed on an outpatient basis and women can return to work in about a week. Da Vinci myomectomy offers women many potential benefits over traditional surgery, including:

If you have fibroids and are interested in preserving your uterus, you may be a candidate for a new uterine-preserving, minimally invasive procedure – da Vinci Myomectomy. Using the assistance of the most advanced combination of surgical and robotics technology available, Dr. Orbuch is able to perform this delicate operation with unmatched precision and control.

Ovarian Cystectomy

Dr. Iris Orbuch uses the da Vinci robot system to treat ovarian cysts using minimally invasive surgery. The da Vinci system with its 3-D High Definition Camera allows for precise removal of ovarian cysts.  The da Vinci system is utilized for Ovarian Cystectomy (removal of an ovarian cyst) or Oophorectomy (removal of an ovary).  Using state of the art technology, a da Vinci Cystectomy or Oophorectomy requires only a few incisions so you can get back to your life faster. With traditional open surgery, recovery time is often 6 weeks with patients’ remaining in the hospital for 2-3 days.  In contrast, after ovarian cyst removal utilizing the da Vinci Robot, a patient only goes home the same day.  If your doctor recommends an Ovarian Cystectomy or Oophorectomy to treat your condition, you may be a candidate for da Vinci Surgery.  Common types of cysts removed utilizing the da Vinci Robot include Endometriomas, Dermoids, Serous/Mucinous Cystadenomas, as well as many others. 

The da Vinci surgery offers women many potential benefits over traditional surgery, including:

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Excision of Endometriosis
Hysterectomy
Myomectomy
Ovarian Cystectomy

Articles about Dr. Iris Orbuch
Read about Dr. Orbuch helping a patient in her struggle with Endometriosis.
Dr. Iris Orbuch Monthy Cosmo Article
Read Dr. Orbuchs weekly column on Cosmo Online.

What is Robotic Surgery?

Robotic Surgery is a special form of surgery that allows specially trained physicians to perform surgery with amazing precisions and accuracy.
Read more about Robotic Surgery

Hospital Affiliations

Midtown Surgery
Center

Midtown Surgery Center

Mount Sinai
Hospital

Mount Sinai

Beth Israel
Medical Center

Beth Israel

Lenox Hill
Hospital

Lenox HIll

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EXCISION OF ENDOMETRIOSIS | HYSTERECTOMY | MYOMECTOMY | OVARIAN CYSTECTOMY | DA VINCI ROBOTIC SURGERY

Dr. Iris Kerin Orbuch | (212) 343-3040 ext. 3 | 202 Spring Street, 2nd Floor | NY, NY 10012