Issue link: https://viewer.e-digitaledition.com/i/992813
An Advanced Surgeon's Toolbox SPECIAL CLINICAL SECTION: WOMEN'S HEALTH da Vinci Robot Minimally Invasive Surgical Platform Cut less, hurt less. Robotics now enable 99 percent of all women's gyn abdominal surgeries to be completed safely through small incisions. Most major surgeries such as hysterectomy, myomectomy and sacro - colpopexy no longer need two- to three-night hospital stays. They are same-day surgeries, which in turn result in less cost, less pain, less narcotic use and fewer complications from wound infections and hernia. EXPAREL Long-acting local anesthetic Replacing older, larger pump-ball modes of delivering postoperative local anes - thetic, EXPAREL uses micro technology to time release bupivacaine directly into the patient's incision sites over three to five days. To further enhance the postop anesthetic eect, D r. Cro cket t i nje c t s it preemptively (before the i nci sion i s even ma de) which helps the nerve not ever feel the pain in the first place. Acessa Modern fibroid blaster Acessa is a new technology emerging for the treatment of fibroids. It uses an array of needle-like projections that the surgeon controls using an intra-abdominal ultrasound guidance system, to fulgu- rate fibroids. A c e s s a i s pa r t ic u l a rly useful in patients seeking future fertility, as it does not weaken the uterine wall as much a s myomectomy or uterine artery embolization. Studies are currently under- way demonstrating safety for vaginal delivery. MatriStem Nonmesh regenerative tissue matrix In the wake of all the law- suits surrounding mesh, new regener at ive t e ch- nologies such as Matristem are emerging. This nonmesh tissue used for pelvic prolapse ( blad- der surgery) maintains and supports the aected area where it is placed. It then ca lls in the patient's own connective tissue cells to the scaolding. It absorbs over time, leaving no perma- nent mesh to hurt or erode! + No more large incisions — One characteristic of high-volume MIGS is that they maintain an open surgery rate of around 1 percent. For patients, this means a 99 percent chance of completing their surgery minimally invasively. + Minimal pain with little or no narcotics — Most patients recover postoperatively using only pre-injected EXPAREL and NSAID for pain control. Tylenol #3 (codeine) is used as a backup only. + Same-day surgery — Most patients who undergo major gyn surger - ies, including hysterectomy, prolapse surgery and myomectomy, go home in four to six hours. + Return to work in three to 12 days — Small-incision surgery patients — even those with major surgery — are typically off all pain meds, cleared to drive and return to work quickly. ■ Typical Patient Expectations SUSAN A. CROCKETT, MD, BOARDCERTIFIED OB/GYN MINIMALLY INVASIVE GYN SURGEON AT VIRTUOSA GYN DRCROCKETT.COM | 2108780090 M D N E W S . C O M /// M D N E W S S A N A N T O N I O ■ 2 018 1 3