by Ashley Barker
Public Relations
The teamwork of two
physicians from different departments was
the reason that Barbara Bozarth, a
coordinator within Education and Student
Life, considered staying at MUSC for her
hysterectomy and sacrocolpopexy.
Dr. Michelle
Koski uses a camera to see inside the
patient prior to inserting the da Vinci
surgical system's arm.
Sealing the decision
for Bozarth was the added bonus of a
robot. Using the da Vinci surgical robot
ensured that she would return to work
weeks earlier than if the procedures were
done with the traditional open surgery
method, which involves a large abdomen
incision.
Ashlyn Savage, M.D., an
assistant professor of obstetrics and
gynecology, recommended in early 2012 that
Bozarth should have a hysterectomy,
removal of the uterus, and a
sacrocolpopexy, repair of the pelvic
prolapse that involves attaching permanent
mesh to the top of the cervix and the
sacrum.
The best option, in her
opinion, would be to have the procedures
done using the da Vinci surgical robot,
which has three wristed-arm instruments
that have 360-degree motion and another
arm that has a camera mounted to it. Once
they're positioned inside the body, the
instruments are controlled by a surgeon
who sits in a console 10 feet away and
maneuvers the arms with joy sticks and
peddles while viewing the inside of the
body with 3-D vision.
Drs. Ashlyn
Savage, center, and Michelle Koski,
right, work together on the patient as
Dr. Jonathan Foote, chief resident in
the Department of OB/GYN, looks on.
Bozarth was initially
torn on what she should do because Savage
could only do the hysterectomy portion of
the surgery. So she began looking for a
urogynecologist, an OB-GYN who also is
trained to treat pelvic organ prolapse,
who could perform both procedures with the
da Vinci surgical robot. Bozarth found a
surgeon in a different state and was
preparing to send her medical records to
start the scheduling process.
While checking the
surgical board one day, Savage noticed a
robotic sacrocolpopexy that was being done
by Michelle Koski, M.D., an assistant
professor of urology who trained on the da
Vinci during her residency and fellowship
in pelvic reconstruction.
"The long arms have a
wrist motion so you can sew, tie and cut
with a tiny, magnified pair of hands,"
Koski said.
Instead of traveling out of state,
Bozarth's surgery was successfully
performed by Savage and Koski with the da
Vinci surgical robot at MUSC on Feb. 7.
Dr. Michelle
Koski maneuvers the da Vinci's arms
while sitting at a console 10 feet away.
"What's unique with
this arrangement is that I'm a
gynecologist and she's a urologist,"
Savage said. "As of now at MUSC, a robotic
hysterectomy and sacrocolpopexy isn't an
option unless we're working together."
Some studies have shown
that the smaller incisions and precise
movements of the da Vinci may make the
patient's hospital stay shorter and
complication rate lower than an open
operation.
Bozarth said she was
home before dinner the day after surgery,
and she had some discomfort during the
first 36 hours but recovered quickly.
"It's absolutely
remarkable," she said. "My friends are in
total disbelief. One is now considering
this option and another is making an
appointment with Dr. Koski."
Da Vinci patients also
are likely to return to normal activities
sooner than patients who had the same
procedures done through a large incision,
according to Koski.
"Patients have similar
activity restrictions after both surgeries
– we have patients avoid lifting more than
five pounds for the first six weeks," she
said. "Everybody is different in terms of
their pain tolerances. But, in general, I
would say the da Vinci probably shaves off
a week or two in terms of recovery."
Drs. Michelle
Koski, left, and Ashlyn Savage make sure
the three armed instruments and camera
of the da Vinci surgical system are in
place.
The use of a robot was
never a concern for Bozarth. It eased her
mind knowing that she would have the best
technology possible.
"The idea of a robot
and two phenomenal physicians working
together was exciting," Bozarth said.
"It's a terrific opportunity that sets
MUSC above the others."
Bozarth wants to make
sure all women know that having a
hysterectomy doesn't mean you have to be
in bed or out of work for two months.
"I think it's a great
opportunity to get the word out. We have
some of the best faculty around, and
they're offering women more options,"
Bozarth said. "They're changing what's
possible."
Friday, Feb.
22, 2013
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