UPMC Video Rounds - Minimally Invasive Gynecologic Surgery

December 18, 2019

 

Suketu Mansuria, MD, assistant director, Minimally Invasive Gynecologic Surgery at UPMC Magee-Womens Hospital: 

Within our division, we're doing a decent amount of both clinical, and also bench research. From a clinical standpoint, we're taking some of the ERAS principles, which stands for Enhanced Recovery After Surgery. These were principles that were developed for laparotomy, for major large cases like Whipples and hemicolectomies. And they were put together to really enhance the post surgical care for these patients. 

We're taking a lot of those principles, and applying them to laparoscopic surgery. What we found is that we're able to decrease post operative nausea/vomiting, post operative pain. We're also doing study with IV acetaminophen, to look to see if that can help decrease narcotic usage.

From a bench research standpoint, we're looking at cytokine expression within endometriosis and see if there is any similarity between endometriosis and ovarian cancer. We're probably one of the busiest centers in the country. And we handle not only routine gynecologic surgery, but we also do a lot more of the complicated cases such as stage IV endometriosis large fibroid uteri and we have a multidisciplinary approach, so that if patients do require bowel or bladder ureteral surgery because of their endometriosis, we're able to involve other minimally invasive surgeons from other specialties, and provide the best care for the patient. 

So I think the future of minimally invasive gynecologic surgery is making it the standard of care for our patients. Nationally, hysterectomies are still being done through a laparotomy or an open approach, whereas at UPMC we've dropped that number drastically. Within our own division it's less than half of a percent.

Some of the things that we're doing is we're training fellows, and we're also training our residents, who are training the next generation of surgeons. So essentially, we're making it the standard of care for our patients to receive minimally invasive surgery at UPMC, and by training these fellows and sending them out to other academic institutions in other cities, we're hoping to spread that and make it the standard of care across the country. 

 

Learn more about gynecology at UPMC Magee-Womens Hospital.