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St. Michael’s makes giant leap in gynecological surgery

Toronto, January 4, 2013

By Emily Holton

Dr. Guylaine Lefebvre performs a myomectomy using the da Vinci System surgical robot.”
Dr. Guylaine Lefebvre performs a myomectomy using the da Vinci System surgical robot. (Photo by Yuri Markarov, Medical Media)

Among the handful of Canadian facilities that own a da Vinci System surgical robot, St. Michael’s Hospital is the only one that regularly uses it to treat non-malignant gynecological disease.

In the U.S., the fastest-growing area for robotics is gynecology. In Canada, da Vinci robots are almost entirely used for men – but St. Michael’s is leading the way with women. Since 2008, Dr. Guylaine Lefebvre and her team have used the robot to perform about 130 hysterectomies and 65 myomectomies (surgery to remove uterine fibroids). The results have been remarkable.

“When we bought the robot in 2008, it was getting a lot of attention for its success with radical prostate surgery in men,” said Dr. Lefebvre, chief of obstetrics and gynecology. “It offered shorter recoveries and less pain for patients. We were inspired! St. Michael’s wanted to bring the benefits to gynecology.”

Dr. Lefebvre can use the da Vinci robot to treat fibroids that would otherwise be too big or too numerous to remove without major open surgery or a hysterectomy. With the robot, not only can Dr. Lefebvre remove fibroids through one tiny incision, she can reconstruct the patient’s uterus. Many of her patients have gone on to have healthy pregnancies.

“It’s incredible the progress that we’ve made,” said Dr. Lefebvre. “Five years ago, many of these women would have had open abdominal surgery with days in hospital and many weeks off of work, not to mention the long-term impact of scar tissue associated with this operation. With the robot, women are home the next day, back at work in a couple of weeks and can get pregnant within a few months.”

The robot was originally purchased for urological surgery, and it continues to shine in that area.

“For any pelvic surgery that requires extensive reconstruction, the robot is faster and more precise than laparoscopic or open surgery,” said Dr. Kenneth Pace, a urologist at St. Michael’s. “When we use the da Vinci to remove kidney tumors, we can often leave a lot of the kidney intact. It means better outcomes, and fewer patients on dialysis afterwards.”

St. Michael’s was the first hospital in Toronto to acquire a da Vinci robot, thanks to a $4.5 million investment by donors. Developed in California, the robot uses three arms to perform surgery while the fourth acts as camera operator and light source.