Atlas of Robotic, Conventional, and Single-Port Laparoscopy

About this book

Minimally invasive surgery has emerged as the standard treatment for many gynecologic diseases and conditions. In the past decade, numerous studies have demonstrated the superiority of laparoscopic approaches over standard open procedures in terms of improved quality of life for patients. Innovations in minimally invasive surgical technology—such as multichannel ports, articulating instruments, and flexible high-definition endoscopes—have made it possible for laparoscopic surgeons to perform increasingly complicated gynecologic surgeries through smaller incisions. As such, since the first edition of the atlas published in 2014, technologies and techniques once considered novel have become standard.

This second edition, with five new chapters and content updated throughout to reflect the latest evolutions in the field, serves as a guide in robotic, conventional, and single-port laparoscopic surgery, presenting invaluable, up-to-date information about instrumentation, surgical technique, port systems, and the current research and development in robotics. Chapters address unique challenges associated with each technique, such as lack of haptic feedback or articulation and instrument crowding, and describe the advanced laparoscopic skills required to safely and efficiently perform procedures, such as how to move and control a flexible camera or use the robot. 

Specific topics include conventional laparoscopic myomectomy, adnexal surgery, total and supracervical hysterectomy, and excision of endometriosis excision, as well as related techniques in gynecologic oncology, urogynecology and pelvic reconstructive surgery, tubal surgery and ectopic pregnancy, isthmocele repair, and trachelectomy for early cervical cancer. For single-port laparoscopic techniques, chapters are presented on adnexal surgery, hysterectomy, and gynecologic oncology, while the section on robotic surgery offers guidance on instrumentation, platforms, and basic principles; robotic-assisted laparoscopic myomectomy, total hysterectomy for benign disease, endometriosis management, and total hysterectomy for cancer; as well as techniques for robotic adnexal surgery, urogynecology/pelvic reconstructive surgery, tubal surgery, and complication management, concluding with a review of new and emerging technologies. 

For students, residents, fellows, operating room personnel, and practicing gynecologic surgeons, the editors share experience amassed while developing novel surgical instrumentation and collaborating on presentations for numerous worldwide events. Internationally renowned experts contribute as well to this practical, illustrated resource on current minimally invasive techniques in gynecologic surgery. 

About the editors

Tommaso Falcone, M.D., FRCS(C), FACOG, is Professor of Obstetrics, Gynecology and Reproductive Biology, at the Cleveland Clinic Lerner College of Medicine. He is presently Chief of Staff, Chief Academic Officer, Medical Director, Cleveland Clinic London. 

Dr. Falcone received his medical degree from McGill University School of Medicine in Montreal, Quebec, Canada. While at McGill, he went on to complete a residency in obstetrics and gynecology and a fellowship in reproductive endocrinology. He is certified by the American Board of Obstetrics and Gynecology in general obstetrics and gynecology, as well as Reproductive Endocrinology. He is also certified by the Royal College of Physicians and Surgeons of Canada and the Royal College of Obstetricians and Gynecologists (UK ad eundem). Dr. Falcone was appointed Chair of the Department of Obstetrics & Gynecology in 2001 and subsequently Chair of the Women’s Health Institute in 2008 to 2018. He was a member of the board of governors of Cleveland Clinic between 2006-2013, member of the Executive Team (ET) from 2007-2010. He served as Vice Chairman of Professional Staff Affairs, Cleveland Clinic from 2007-2014.Dr. Falcone has published more than 500 original manuscripts, abstracts, and book chapters. He is co-editor of 8 books including a textbook on Clinical Reproductive Medicine and Surgery (Springer third edition 2017); Operative Techniques in Gynecologic Surgery (Wolters Kluwer 2017). He has served on the editorial board of several journals, including Associate Editor of Fertility & Sterility and the Editorial Board of the Obstetrics & Gynecology (Green journal). He is presently editor-in-chief of JMIG. He is past President of the Society for Reproductive Surgeons (SRS) and Past Chair of the Endometriosis special interest group of the ASRM. He is President of the International Society for Fertility Preservation (ISFP-2019-2020). He has served on review committees for NICHD and MRC. Dr. Falcone has been the recipient of many awards for laparoscopic and robotic surgery at different societies. He was a senior author on the first publication on gynecologic robot surgery and a member of the team that performed the first uterus transplant in the USA.

Pedro F. Escobar-Rodriguez, MD, MHL, FACOG, FACS is the Director of Gynecologic Oncology and Minimally Invasive Surgery at San Jorge's Children & Women's Hospital in San Juan, Puerto Rico. He holds an academic appointment as Associate Professor of Obstetrics and Gynecology at The University of Puerto Rico, School of Medicine and Ponce Health Sciences University, Ponce, Puerto Rico. He graduated residency in Obstetrics and Gynecology at Prentice Women's Hospital at Northwestern University in 2002 and a fellowship in Gynecologic Oncology and Breast Surgical Oncology at the Cleveland Clinic in 2006. He then completed a Master of Science (ScM) in Healthcare Leadership from Brown University. He has authored and co-authored over 100 scientific publications and has written numerous book chapters, monographs, and invited articles. Dr. Escobar is very active nationally and internationally, and is considered an expert in the field of minimally invasive gynecologic cancer surgery. Dr. Escobar is also committed to the education of surgeons and staff; he is frequently invited to lectures, meetings, and surgical labs, nationally and internationally. He served on the board of trustees of the American Association of Gynecologic Laparoscopist (AAGL) and currently serves on the editorial board of the International Journal of Gynecologic Cancer and the Journal of Minimally Invasive Gynecology.

Contents

Part I Conventional and Reduced-Port Laparoscopy

1. 1  Basic Principles and Anatomy for the Laparoscopic
   Surgeon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Amal Saad, M. Jean Uy-Kroh, and Tommaso Falcone

2. 2  Laparoscopic Myomectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Megan S. Orlando and Rosanne M. Kho

3. 3  Laparoscopic Adnexal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Anna Fagotti, Cristiano Rossitto, Sara Pizzacalla, and
   Giovanni Scambia

4. 4  Laparoscopic Total and Supracervical Hysterectomy . . . . . . . . . 53 George Thomas and Michael L. Sprague

5. 5  Laparoscopic Excision of Endometriosis . . . . . . . . . . . . . . . . . . . 65 Angelina Carey-Love, Miguel Luna-Russo,
   and Cara R. King

6. 6  Techniques in Gynecologic Oncology . . . . . . . . . . . . . . . . . . . . . . 75 Travis T. Sims and Michael Frumovitz

7. 7  Laparoscopic Hysterectomy for Oncologic Patients . . . . . . . . . . 87 Stephanie Ricci and Erika J. Lampert

8. 8  Techniques in Urogynecology and Pelvic Reconstructive
   Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . 95 Cecile A. Ferrando and Beri Ridgeway

9. 9  Techniques in Reproductive Surgery . . . . . . . . . . . . . . . . ..... . 111 Nisha Garg, Elizabeth W. Patton, and Magdy P. Milad

10. 10  Surgical Repair of the Symptomatic Isthmocele . . . . . . . ..... . 121 Charles E. Miller and Kirsten J. Sasaki

11. 11  Laparoscopic Trachelectomy . . . . . . . . . . . . . . . . . . . . . . . ..... . 133 Natalia del Mazo-Arbona, Natalia R. Gómez-Hidalgo,
    and Pedro F. Escobar

12 13

Single-Port Laparoscopic Adnexal Surgery . . . . . . . . . . . . . . . . . 143 Julia Nicole Chalif, Sabrina Marie Bedell,
and Chad M. Michener

Single-Port Laparoscopic Hysterectomy. . . . . . . . . . . . . . . . . . . . 157 Kevin J. E. Stepp and Anjana R. Nair

Part II Robotic Surgery

14. 14  Robotic-Assisted Total Laparoscopic Hysterectomy . . . . . . . . . . 171 Danielle B. Chau and Peter G. Rose

15. 15  Principles of Robotic Myomectomy. . . . . . . . . . . . . . . . . . . . . . . . 183 Antonio R. Gargiulo

16. 16  Robotic-Assisted Surgical Management of Endometriosis . . . . . 191 Katherine de Souza and Lindsey N. Valentine

17. 17  Techniques for Robotic Urogynecology and
    Pelvic Reconstructive Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 Heather M. Winn, Megan E. Tarr, and Marie Fidela Paraiso

18. 18  Techniques for Robotic Tubal Reanastamosis . . . . . . . . . ..... . 219 Salomeh Salari and Rebecca Flyckt

19. 19  Techniques for RoboticAdnexal Surgery. . . . . . . . . . . . . ..... . 225 Kristina A. Butler and Javier F. Magrina

20. 20  Management of Complications . . . . . . . . . . . . . . . . . . . . . ..... . 235 Ghiara A. Lugo Diaz, Mikel Gorostidi Pulgar,
    and Pedro F. Escobar

21. 21  Novel Technology in Robotic Surgery . . . . . . . . . . . . . . . . ..... . 247 Mahmoud Abou Zeinab and Jihad Kaouk

Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259