Better outcomes for hysterectomies performed with robotic surgery

The decision to have a hysterectomy is a personal and often emotional choice many women make. Fortunately, there are several options that can help make both the surgery itself and the recovery process minimally disruptive to women’s lives. One of those options is a robotic, or da Vinci®, surgery.

“A hysterectomy, which is a surgery that removes a woman’s uterus, can lead to complications that can be minimized by robotic surgery,” said Victor Casiano, M.D., an obstetrician-gynecologist at the Institute for Women’s Health, San Antonio. “Recent studies have shown better clinical outcomes for benign hysterectomies for women who opted not to undergo conventional abdominal, vaginal and laparoscopic hysterectomies.”

The da Vinci Surgical System is designed to help surgeons perform minimally invasive surgeries. Rather than performing a traditional operation, the surgeon uses the robotic surgery system to gain magnified views via specialized instrumentation including a miniaturized surgical camera and other instruments. This allows for precise dissection and reconstruction during complex internal surgeries, which in turn reduces recovery times and risk of complications for the patient. Robotic surgeries are performed while the patient is under general anesthesia, and incisions are tiny – usually only three or four incisions are made near the belly button

“Depending on the patient’s specific circumstances, robotic surgeries can be most beneficial,” Dr. Casiano said. “I’ve seen, first-hand, the outcomes of complex cases performed with the da Vinci Surgical System as opposed to traditional methods of surgery. Typically, the more delicate procedures require assistance with robotic surgery.”

Patients who undergo robotic-assisted hysterectomies share a variety of risky co-factors: advanced age, obesity and larger uteruses than what is typical. Other reasons a doctor may recommend robotic surgery include uterine conditions such as endometriosis, chronic pelvic pain and both cancerous and non-cancerous tumors.

“Recent studies show that women who undergo hysterectomies assisted with robotic surgery experience significantly lower reoperation rates and hospital readmissions than women who underwent traditional surgeries,” Dr. Casiano said. “Any type of surgery has the potential to be disruptive to a patient’s life, so our goal is to get them back to their normal routine as quickly as possible.”

If you’re considering a hysterectomy, talk to your OB/GYN about whether or not you may be a candidate for robotic surgery. They can further explain the risks and benefits specific to you.

Victor Casiano, M.D., is an obstetrician-gynecologist with the Institute for Women’s Health, San Antonio. To schedule an appointment with Dr. Casiano, please call 210.226.9705.

This Article Originally Appeared on https://www.ifwh.org/en/better-outcomes-for-hysterectomies-performed-with-robotic-surgery/

Bank On It: Cord Blood Banking Awareness Month

July is Cord Blood Awareness Month Across the Nation and we are proud to support programs that make efforts to reach expectant parents across the nation with useful facts and tips on why and how to save a newborn’s cord blood. Cord blood and tissue taken from the umbilical cord at birth can be used to treat more than 80 diseases, including blood cancers, lymphoma and leukemia.

Expectant parents are bombarded with information about the delivery process and many other things that fall along with the procedure. It must be nearly impossible to decipher the medical terms and really understand what options expectant parents have in terms of doctors, facilities, pre- and post-partum care. This is why Save the Cord Foundation exists. They are structured to guide you through this process of storing your baby’s cord blood. The foundation wants to explain how this fits into your birthing process without disruption to you or your baby. They are interested in helping you understand why it is important to not throw this natural resource away and then learn about options in your area to save your newborn’s cord blood either publicly or privately. One of their main goals is to help the expectant parents, understand how valuable your baby’s cord blood is and make sure that it is not just thrown away (around 95% of cord blood is thrown away currently as medical waste). Unfortunately, it is often the parent who must ask about donating or privately storing cord blood as this topic is not commonly brought up in birthing consultations. This is why it is important for parents to educate themselves and understand their options.

Not to mention, the Institute for Women’s Health OB/GYN Care in San Antonio, Texas, is interested in sharing their expertise on why parents-to-be should consider this important procedure. Making this decision prior to giving birth could potentially save your child’s life.

If you’re wondering how cord blood transplants work, it’s simple, cord blood can be used in treatment for over 80 different diseases, including certain types of cancer. After collection, cord blood is administered to a patient that needs healthy, adaptable stem cells in their system. These cells begin repopulating inside the body, which speeds up the patient’s treatment process and improves their chances of a successful recovery.

There are doctors who have noted a few benefits of cord blood stem cell transplants:

●     Cord blood cells multiply very quickly. While the amount of stem cells collected from cord blood is lower than other stem cell procedures, hematopoietic stem cells (HSC), from the umbilical cord generate new cells at a faster rate. Researchers are also experimenting with ways to increase the number of stem cells given to a patient, such as using two different cord blood units in the same procedure.

●      HSCs from cord blood naturally move to damaged areas. After HSCs are transplanted into a patient, cord blood cells will move through the blood system to the area where they are needed most. Once they arrive, the transplanted HSCs work with the body’s cellular system to repair damage.

●     Umbilical cord cells are more adaptable than other types of HSCs. Compared to bone marrow and peripheral blood transplants, cord blood cells are younger and more immature. This means HSCs from the umbilical cord have a much higher chance of adapting to the patient’s system, preventing graft-versus-host disease. Bone marrow usually requires a 5 out of 6 HLA match or higher, while many scientists suggest cord blood HSCs only require a 3 out of 6 match.

Doctors and researchers are constantly improving the treatment methods they use during stem cell procedures. While cord blood treatments, and stem cells in general, are still considered an emerging science, dozens of diseases are currently approved for cord blood therapy by the FDA.

As mentioned before on how cord blood is used to treat diseases, to be exact, cord blood HSCs have been used in treatment for over 20 years, with over 35,000 transplants completed worldwide. Since the first successful cord blood treatment in 1988, doctors have utilized umbilical cord cells as a therapy for dozens of different illnesses. Cord blood HSCs now treat over 80 different conditions — in the past 8 years, the list of diseases treated with cord blood has doubled.

HSCs can be used as a treatment for:

●     Blood cancers like leukemia and lymphoma

●     Immune system disorders like aplastic anemia

●     Metabolic conditions like Hurler syndrome and Krabbe disease

Once the cells are injected into a patient’s system, they make its way through the bloodstream to damaged areas like the brain, heart, or other vital organs. After they arrive, the cells adapt into the type of cell most needed by the body, and begin multiplying. This increases the patient’s healthy blood cell count and improves their recovery time.

When choosing the right option for your family, remember there is no wrong answer — private and public banking each have their own benefits and drawbacks. There are a few major factors that can help you make the best choice for your situation:

●     Price — private banking costs money, usually a processing fee upfront and annual payments to keep your child’s cord blood in storage. Donating cord blood to a public bank is completely free.

●     Location — Public banks are usually associated with a hospital, which means your options are limited depending on your location. Most private banks offer temperature-controlled storage, allowing parents to ship their child’s cord blood over long distances. Location is less important to private banking.

●     Family history — A family that has a history of genetic disease would benefit more from private banking, where they can use banked stem cells as a treatment for immune disorders and metabolic conditions. The chances of the donor family using a public banking donation again are low, since the cells will most likely be used for another treatment by the time the family needs them.

Knowing more about your options can help you make the most informed decision for your family. For more information on choosing between private and public banking, read our banking options guide.

In case you were wondering how cord blood banking works, after your child is born, their umbilical cord is clamped and cut just like in a normal birthing procedure. Medical staff will move the cord to a different room where they extract blood from the cord and place it into a storage container.

A cord blood unit traveling to a storage facility goes through several basic steps:

●     The cord blood is placed into a temperature-controlled container at the hospital.

●     The container is shipped through a private medical carrier to the storage facility.

●     Facility staff will remove stem cells from the cord blood.

●     The cells are placed into long-term cryogenic storage, ready to use whenever needed.

If you’ve decided to store your child’s cord blood in a private bank, only your family will have access to these stem cells. You can use them as a treatment for your child, siblings, or close relatives at any point in the future. Parents that donate cord blood won’t have any control over their stem cells, but often receive notifications from the public bank if their cells are used to treat a patient.