Looking Ahead: Robotic Surgery for Gynecologic Cancers

Shana Wingo, M.D., discussed advancements being made in the field of surgery for patients with gynecologic cancers.
BY Danielle Bucco
PUBLISHED April 26, 2017
Robotic technology is moving into the realm of gynecologic cancers, paving the way for minimally invasive surgery for complex operations.

“The majority have adopted robotic surgery and minimally invasive technology in uterine malignancies, cervical cancer, and some early-stage ovarian cancers, where a surgeon is doing more of a staging procedure and not a tumor debulking,” Shana Wingo, M.D., said during an interview with CURE.

According to Wingo, minimally invasive robotic surgery is comparable to laparoscopy and has been shown to have better recovery rates for patients. As the technology continues to improve, only a single incision is needed to conduct the surgery, as opposed to the typical multiport surgery.

“Some institutions are exploring the utility of a single site. The technique is a slightly bigger incision, but all the instruments come into one area, meaning you do not have multiple incisions,” explained Wingo.

Wingo, a gynecologic oncology surgeon at Arizona Oncology, discussed advancements being made in the field of surgery for patients with gynecologic cancers.

What surgical advances are you excited about across gynecologic malignancies?

More oncologists are doing minimally invasive surgery. In ovarian cancer, it's more difficult to adapt a minimally invasive approach as this is known to be a bulkier malignancy. The majority have adopted robotic surgery and minimally invasive technology in uterine malignancies, cervical cancer, and some early-stage ovarian cancers, where a surgeon is doing more of a staging procedure and not a tumor debulking.

In some institutions, where surgeons have more experience with robotic surgeries, there are more aggressive procedures being done. An exciting development is the technology for minimally invasive surgery continues to increase in quality. Typically, what is done is a multiport surgery when a physician is doing laparotomy robotics. Some institutions are exploring the utility of a single site. The technique is a slightly bigger incision, but all the instruments come into one area, meaning you do not have multiple incisions.

Time will tell if these methods get adopted, but in endometrial cancer it's been studied to have better recovery for the patients. 

What do you find to be exciting about this technology?

It is hard to know what innovators will do. Every time we think we have reached our maximum potential, some intelligent engineer develops new technology that takes it a step further. 

One of the important techniques that’s used is sentinel lymph node detection. When you do robotic surgery and laparoscopic surgery, you can inject dye into the cervix and identify the first lymph node that's draining a specific area, such as the cervix or uterus. There is also infrared detection technology determining where the lymph nodes are. I think the engineers do a phenomenal job of improving upon technology that we never would have imagined existed. 
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