Robotic Surgery Provides a Minimally Invasive Option for Ovarian Cancer Patients
The term “robotic surgery” can be frightening. There are so many questions surrounding the emerging technology and its efficacy and safety. However, robotic surgery is paving the way for less invasive options when it comes to many types of surgery, especially for complex gynecological cancer operations.
In honor of Ovarian Cancer Awareness Month, we’re discussing ovarian cancer — the fifth-leading cause of cancer death in women — and the benefits of robotic surgery for those battling the disease.
Ovarian cancer develops in the ovary and falls into one of four categories: epithelial, stromal, germ cell and small cell. The most common type of ovarian cancer is of the epithelial variety, affecting 90 percent of those diagnosed. Although serious, ovarian cancer has a five-year survival rate of 92 percent if caught early, but only 15 percent of diagnoses are made early.
The traditional method for treating ovarian cancer involves a laparotomy in which a surgeon makes an incision about 15 to 20 centimeters long below the bikini line, similar to the cut made for a caesarean section. This procedure requires a hospital stay of four to seven days and a three- to four-week recovery period before starting chemotherapy, for most cases.
Robotic surgery is a minimally invasive approach to surgery that adds the power of computing to surgical movement. Also called computer-assisted or robot-assisted surgery, this approach does not require a large incision. Instead, surgeons work using miniaturized instruments that fit through a series of quarter-inch incisions. The instruments contain cameras that guide surgeons with images viewed on a computer screen.
The smaller incisions, shorter hospital stay and earlier return to normal activity are what interest most patients who are considering robotic surgery, says Kenneth Hancock, M.D., a gynecological oncologist and physician on the medical staff at Texas Health Fort Worth.
“If the patient is a candidate, the surgery allows a much quicker recovery with less pain,” says Hancock. “This often means chemotherapy, if needed, can be started sooner.”
A common misconception about robotic surgery is that a robot will be performing the procedure, but all movements are controlled by the surgeon. The controls that the surgeon operates translate the movements of their twisting wrists. This allows for much more dexterity — up to 760-degree movement compared to conventional surgery or laparoscopic surgery.
“Since the instruments have seven degrees of motion versus the standard two degrees, it allows us to use all of the motions of our hands as we normally would,” Hancock explains. “We are able to perform procedures that are very difficult or impossible with standard surgery.”
Currently, there is no standard screening test for ovarian cancer; although pelvic exams do occasionally detect ovarian cancer, in most cases the cancer is already at an advanced stage upon detection. Therefore, becoming familiar with the common symptoms of ovarian cancer is highly important.
Women should consult their physician if they persistently experience any of the following symptoms:
- Abdominal swelling or pain
- Abnormal bloating
- Trouble eating or feeling full quickly
- Pain in the back or pelvis
- Urinary symptoms, such as urgency or increase in frequency
Certain risk factors can also increase a woman’s chance of developing ovarian cancer. Some can be changed, while others cannot. Factors that increase your risk of ovarian cancer include:
- Age — The risk of developing ovarian cancer increases with age. Half of all ovarian cancers are found in women 63 years of age or older.
- Weight — Obesity has been linked to a higher risk of developing many cancers.
- Childbearing — Women who have their first full term pregnancy after age 35 or who have never carried a pregnancy to full-term have a higher risk of ovarian cancer.
- Family history — Ovarian cancer can run in families. Your ovarian cancer risk is increased if your mother, sister or daughter has or has had ovarian cancer.
- Breast or colon cancer — Women who have had breast cancer or have a family history face a higher risk of developing ovarian cancer.
Ovarian cancer cannot be prevented in most cases, but women can take steps to decrease their risk of developing the disease. One way is to use oral contraceptives. Women who have used birth control pills for more than five years reduce their risk by 50 percent, compared to women who have never taken oral contraceptives.
Another way to decrease risk is to undergo a hysterectomy or the removal of the fallopian tubes and ovaries. Studies show that removing the fallopian tubes and ovaries of premenopausal women with the BRCA1 or BRCA2 genetic mutation can reduce the risk of ovarian cancer by 85 to 95 percent and breast cancer by 50 percent.
While Hancock says robotic surgery may not be the right course of treatment for all ovarian cancer patients, its lower risk for complication, smaller incisions and shorter recovery rates make it a compelling option to explore for the right candidate.
Knowledge is power in the fight against cancer. The physicians and employees of Texas Health Resources hospitals are dedicated to providing information to help you make sense of your cancer diagnosis and treatment options. If you would like more information about the cancer care at a Texas Health hospital near you, please visit TexasHealth.org/Services/Cancer.
To find an OB/GYN, please visit TexasHealth.org/Provider.