Robotic Surgery for Early-Stage Ovarian Cancer

Robot-assisted surgery is used to treat early-stage ovarian cancer in cases where the cancer is thought to be confined to the ovaries. For this condition, the standard treatment, utilized by most patients, is a robotic simple hysterectomy (involving removal of the uterus and cervix), along with bilateral salpingo-oophorectomy (surgical removal of both ovaries and fallopian tubes) and a series of staging procedures, in which tissues are sampled to gauge the extent of the cancer—a key step that is used to guide post-operative chemotherapy and other future treatments (see below).

For patients wishing to preserve fertility, the preferred approach is a unilateral (fertility-sparing) salpingo-oophorectomy together with a D&C (dilation and curettage), in which the surface layer of the uterus lining is surgically scraped. The uterus and the non-diseased ovary are left in place to preserve future fertility. This operation also includes staging procedures to evaluate how far the cancer has progressed and guide future treatment (see below).

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Staging Procedures for Early-Stage Ovarian Cancer

In addition to the procedures mentioned above, a number of other surgical steps are also performed at the same time as a standard part of the surgical treatment for early-stage ovarian cancer. These steps, in which tissue is removed in order to analyze it for the presence of cancer cells, are called staging procedures. They are critical since they enable the oncologist to determine the extent of the cancer, which in turn will guide decisions on chemotherapy and other aspects of treatment. The standard staging procedures for early-stage ovarian cancer are pelvic and para-aortic lymph node dissection (a sampling of tissue from the lymph nodes in the pelvis and abdomen), omentectomy (surgical removal of the fatty covering of the abdomen), a peritoneal washing (in which the interior of the belly is washed out with saline solution to determine if any cancer cells are present), and peritoneal biopsies (multiple tissue sampling of the lining of the abdomen). As with other operations involving delicate dissection, the superb visualization and controlled precision offered by the da Vinci Si surgical system is ideally suited to these staging procedures.

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