ABOUT

DR DEVIN GARZA | da Vinci ® Robotic surgeon with 1600+ procedures.

In 2017 alone, 260 robotic cases performed.

118 hysterectomies

Large percentage physician referrals

100% Minimally Invasive Surgery

42/43 Robotic Complex Myomectomies

The only surgeon in Austin/SanAntonio area performing robotic Transabdominal cerclages

Pioneering robotic use of Acessa RFA treatment of Fibroids

Endometriosis excisional cases of course

LOCAL SURGEON WITH WORLDWIDE RECOGNITION

Dr. Devin M. Garza, a OB/GYN Surgeon, of Renaissance Women’s Group in Austin, Texas is specially trained and nationally proctors and instructs surgeons in the unique procedures of da Vinci Gynecologic Surgery. Dr. Garza has performed or instructed more than 1500+ procedures.

He is also the Assistant Clinical Professor of Women’s Health for The  University of Texas at Austin Dell Medical School.

Dr. Garza has personally instructed well over 1,100 surgeons hands-on to advance their minimally invasive robotic surgery skills. His case observation site is the busiest case observation site in the U.S.

National Recognition

Dr. Garza is among 29 distinguished U.S. surgeons designated as an Epicenter Surgeon. Surgeons from all over the U.S. fly in to watch Dr. Garza perform surgery and learn state of the art techniques in the robotic management of complex and benign hysterectomy, myomectomy, endometriosis, pelvic floor prolapse and other surgeries.

International Recognition 

Dr Garza is recognized nationally and internationally for his contribution to develop Single-Site DaVinci Surgery for use in Gynecology.

  He is also regularly instructs Advanced and Masters level Robotic Surgery, and accepts referrals for COMPLEX cases.

 Dr Garza also teaches Advanced and Masters robotic training courses for new and experienced robotic surgeons. He participated as faculty at World Robotics Gynecologic Congress (WRGC) and the American Association of Laparoscopic Gynecologists (AAGL) where he presented on the new reduced port and Single Site technology platform to an international audience of robotic surgeons, and instruct surgeons on hand’s on training.

Single incision robotic hysterectomy provides me with  a complete single surgical platform to offer my patients.  This is an amazingly cosmetic approach to their laparoscopic surgery.  Not every patient will be a candidate for a single incision approach, but many will find that they can have their surgery performed in this way.”

Da Vinci® Surgery is the latest technological platform providing safe and effective minimally invasive surgery- giving more options for millions of women needing surgery. “The 3-D vision and wristed articulation of instrumentation produces increased precision and less discomfort for my patients.”

Click here for Dr Garza’s Personal & Professional CV

PROFESSIONAL AFFILIATIONS

Click Below for More Information: 

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ABOUT PICS
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Devin Garza MD, FACOG is a part of Renaissance Women’s Group, and affiliated with St David’s North Austin Medical Center and Texas Institute of Robotic Surgery.

FINANCIAL DISCLOSURE

Dr. Garza is passionate about improving patient outcomes in the minimally invasive setting of robotic surgery for Gynecology.  His extensive surgical experience and designation as an Epicenter/Mentor expert in the field of robotic surgery allows him the privilege to teach advanced and masters courses, lecture nationally and internationally, and host surgeons from all over the world that observe him performing surgery.   He has helped to develop techniques and instruments that further the progress of minimally invasive surgery.

For his consultative and educational work and extensive time commitment away from his regular medical practice, Dr. Garza receives income in the form of service-based honoraria, and travel expenses paid for by: Intuitive Surgical and Applied Medical.  Dr. Garza is not paid to use certain products, instruments or medications.

As a referral surgeon, the vast majority of cases are complex, and patients are referred to Dr. Garza by their physicians to avoid a large incision and the associated longer recovery  and increased risk of complications.  Other patients are seeking another option for a minimally invasive approach due to being offered only a laparotomy/large incision and longer recovery.

Dr Garza’s outcome data over past 2 years for successful Minimally Invasive Robotic approach:

HYSTERECTOMY:     207   =  99%

MYOMECTOMY:       77  =    96%

SACROCOLPOPEXY: 27 =    100%

To date, as an expert minimally invasive surgeon educator, Dr Garza has personally  trained over 1,500 surgeons.   The impact of that training continues to improve patient outcomes across the U.S., and I hear routinely from other surgeons how their skillset has improved on an ongoing basis.

Over 60  Advanced/Masters courses

Over 200 proctored cases teaching in other surgeon’s O.R.s

Over 150 Minimally Invasive Surgery lectures

Over 200 surgeons trained during case observations visiting me from all over the world.

PROFESSIONAL SERVICES

GYNissues

GYNECOLOGIC ISSUES

Abnormal Bleeding

Abnormal bleeding can be experienced as either abnormally heavy cycles, or abnormal timing of bleeding, or sometimes both.    Abnormal bleeding is important, and can be caused by many different reasons: abnormalities of the uterus, cervix, vagina, hormonal system or any combination can ultimately be the reason for significant or subtle changes in a woman’s menstrual cycle causing abnormal bleeding.

The evaluation for the cause of abnormal bleeding is, therefore, very important, because knowing what is or is not present will help determine the choice of therapy.  Although often age-dependant, there are some very serious causes of abnormal bleeding which could be the only warning sign for cancers specific to women.    Some of the most common causes include: fibroids (uterine muscle tumors), polyps of the uterus (growths of the endometrial tissue which is glandular tissue that lines the uterine cavity), hormonal issues leading to lack of predictable ovulation, cervical inflammation, cervical polyps, pevic infection.

Some reasons for abnormal bleeding are managed with medication and a “wait and see” approach, while others can only be managed through surgery, which most often is a minimally invasive outpatient approach called Laparoscopy.  (see “When Surgery Is Needed” below)

Pelvic Pain

Pelvic pain is important, and can be caused by many different reasons:  ovarian, fallopian tube, uterine, internal pelvic changes due to endometriosis, scar tissue/pelvic adhesion, bladder, bowel, or musculo-skeletal issues.

The evaluation for the cause of pelvic pain is, therefore, very important, because knowing what is or is not present will help determine the choice of therapy.  A thorough discussion with my patient and examination is critical in addition to imaging studies such as ultrasound (sonography), CT scan, and MRI are commonly performed to help narrow down the most likely causes, but often, an outpatient surgery called a Diagnostic Laparoscopy is needed. Laparoscopy provides the unique and invaluable visual approach needed to not only visualize the problem, but to manage the problem causing pain. (see “When Surgery Is Needed” below)

Fibroids

Fibroids are a very common uterine isssue.  A fibroid is a benign, non-cancerous muscle tumor.   Many cause little or no symptoms, and they come in various number and various sizes.  They can grow or remain stable and seldom regress.  Most commonly, fibroids can cause abnormal heavy bleeding, abnormal timing of bleeding, painful menstrual cycles , or often all of the above.  They can cause pelvic pain, complicate pregnancies, and sometimes lead to infertility and miscarriages.  Rarely, what appears to be a fibroid on an ultrasound-which is our most common means of diagnosis – is actually a rare and very serious cancer.

The evaluation of fibroids, therefore, very important, because knowing exactly how many are present and their precise location  will help determine the choice of therapy.  A thourough discussion with my patient and examination is critical in addition to imaging studies such as ultrasound (sonography), CT scan, and MRI are commonly performed to help narrow down options.  Sometimes surgery is clearly the best option in order to have a definitive 100% removal of the fibroid/fibroids.  For me, most often an outpatient surgery called a Robotic Laparoscopy (DaVinci) is the approach I use to manage these cases effectively. (see “When Surgery Is Needed” below)

Painful Menstrual Cycles

There are several common reasons for severely painful menstrual cycles including endometriosis, fibroids, infection and less understood neurochemical pain syndromes.  The evaluation for the cause of severe menstrual pain is, therefore, very important, because knowing what is or is not present will help determine the choice of therapy.

A thourough discussion with my patient and examination is critical in addition to imaging studies such as ultrasound (sonography), CT scan, and MRI are commonly performed to help narrow down the most likely causes, but often, an outpatient surgery called a diagnostic Laparoscopic evaluation is needed. Laparoscopy provides the unique and invaluable visual approach needed to not only visualize the problem, but to manage the problem causing painful cycles. (see “When Surgery Is Needed” below)

Painful Sex

There are several common reasons for painful sex.  These include endometriosis, ovarian cysts, adhesions of pelvic organs, infection.  The evaluation for the cause of painful sex is, therefore, very important, because knowing what is or is not present will help determine the choice of therapy.

A thorough discussion with my patient and examination is critical in addition to imaging studies such as ultrasound (sonography), CT scan, and MRI are commonly performed to help narrow down the most likely causes, but often, an outpatient surgery called a diagnostic Laparoscopic evaluation is needed. Laparoscopy provides the unique and invaluable visual approach needed to not only visualize the problem, but to manage the problem causing pain.

For me, my experience-based approach to this evaluation and management is the DaVinci platform for Laparoscopy. (see “When Surgery Is Needed”)

Endometriosis

Endometriosis is a frequent finding in patients with painful sex, severely painful cycles and pelvic pain.  Endometriosis is a condition unique to women where the lining of the uterus is no longer confined to the inside of the uterus, but is identified outside of the uterus and implanted onto the lining of the pelvis and pelvic organs such as the ovaries, fallopian tubes and uterus. This can lead to abnormal adhesions, which essentially can be thought of as a kind of abnormal “biologic glue” and can lead to pain, infertility or sometimes can be completely without symptoms.  It is still poorly understood why some women have minimal findings at surgery and suffer enormous life-altering pain, while some women with the most complex severe findings have minimal or no symptoms.  It is most widely presumed (although not universally accepted) that the endometrial tissue finds it’s way into the pelvis by being “squeezed” backwards up the fallopian tubes during typical menstrual cramping activity during a normal menstrual cycle.   It is unclear why this tissue implants in some women and not others.

The diagnosis of endometriosis is only made with certainty at laparoscopic surgery visually and with biopsy.  The treatment is also with surgical removal of these implants and release of the adhesions in order  to restore the anatomy to as close to normal as possible.  Laparoscopy provides the unique and invaluable visual approach needed to not only visualize the problem, but to manage it.  For me, my experience-based approach to this evaluation and management is the DaVinci platform for Laparoscopy. (see “When Surgery Is Needed”)

When Surgery Is Needed

Dr Garza’s experienced-based choice for advanced and basic laparoscopic evaluation and management is called DaVinci Robotic Laparoscopy.  The advantages of this platform are the improved High Definition 3-D vision, possibility of high image magnification, and instruments that have what surgeons call “wrists” which allow for an approach similar to their own hands, more so than what they could ever accomplish through non-wristed instrumentation.  Putting these very important advances together, more precise surgery is possible vs what was done before with traditional laparoscopy.  Since mastering this platform, Dr Garza has performed over 1,000 times since 2006, and his patients rarely need a large incision to manage problems that require surgery.   The obvious benefit to an open incision is less pain, faster recovery and return to normal life.  In short, Dr Garza can honestly say the Davinci platform makes him a more confident, more precise and all around better surgeon for his patients.

He is also dedicated to the benefits of minimally invasive surgery and the value that robotic surgery gives his patients. Dr Garza also regularly lectures, teaches and assists with hands-on training with other surgeons at all skill levels to be better surgeons, and help give their patients the best outcomes they can when they use this type of surgical platform.   Surgeons from all over the US and other countries make trips to come and watch the him perform these surgeries and learn ways to improve their own skillset or learn a new approach.

On rare occasions, an open incision is best and safest approach to manage very unique and complex pathology.  Dr Garza frequently has patients with complex and chronic pathology referred to him for management of their problems in order to avoid a large incision, and the DaVinci approach is his “go to” for these cases as well as cases that are seemingly easier based on information pre-operatively, because in his experience, he never knows exactly what he’s going to find once he places the scope inside an abdomen and views it.  He wants to utilize the best “tool kit” in his hands to perform the best surgery possible.

surgical lite

SURGERY

da Vinci® SURGERY

An essential part of caring for women is providing leading edge, evidence-based and safe surgical solutions. Staying at the forefront of surgical research and technology has been a key priority for Renaissance Women’s Group. We are proud to say that our ObGyns are leading providers of gynecological surgery in the Austin and Central Texas area.

Minimally Invasive, Maximum Comfort

As part of our mission to provide the least invasive, most effective and comfortable treatment options to our patients, we continually seek out new, minimally invasive surgical approaches, including the new, groundbreaking robotic da Vinci® Surgical System.

We are pleased to announce that all our ObGyns are certified Robotic da Vinci® Surgeons, and utilize this advanced technology in many, if not most, of our major surgical cases.

Using the robot and other minimally invasive techniques, traditional “open” or “large incision” surgery can almost always be avoided, significantly reducing hospital stays and post operative pain, and allows our patients to get back to normal activities weeks faster.

Due to our intensive training focus and dedication to maximizing our use of minimally invasive techniques, our group’s need to resort to open surgery has been successfully reduced year after year, such that at the current time open surgery is very rare.

What is Robotic Surgery?

With the da Vinci® surgical method, your ObGyn will insert the robotic surgical instruments through one or more small skin incisions. These instruments are then “docked” with the robot. Your doctor then moves to a console where he or she can visualize remotely a detailed view of the pelvis through two highly specialized 3D cameras located on the robotic tools, and use his or her hands to remotely control the surgical tools –the robot’s “arms”– and perform the surgical procedure. The robotic technology allows for enhanced visualization, dexterity and precision, maximizing the surgeon’s abilities to perform complex surgery while maintaining the minimally invasive benefits.

SINGLE SITE SURGERY

Dr Garza was among the first in the world to help develop this procedure and is among the surgeons worldwide with the highest case volume of procedures. He is a leading expert in da Vinci® Single-Site® Surgery: A Virtually Scarless Procedure.

If your doctor recommends you have a hysterectomy for a gynecologic condition, ask about all treatment and surgical options, including da Vinci Single-Site Hysterectomy*.

With state-of-the-art da Vinci Single-Site, doctors remove your uterus through a small incision in your belly button. Patients who choose da Vinci Single-Site Surgery experience virtually scarless results, similar to single incision traditional laparoscopy.

As a result of da Vinci technology, da Vinci Single-Site Hysterectomy offers the following potential benefits:

  • Low blood loss1
  • Low rate of converting to traditional laparoscopy and open surgery1
  • Low rate of complications1
  • Short hospital stay1
  • Small incision for virtually scarless results1

Risks & Considerations Related to Hysterectomy for benign conditions, including da Vinci Single-Site Surgery:
Injury to the ureters (ureters drain urine from the kidney into the bladder), vaginal cuff problem (replaces cervix): scar tissue in vaginal incision, infection, bacterial skin infection, pooling/clotting of blood, incision opens or separates, injury to bladder (organ that holds urine), bowel injury, vaginal shortening, problems urinating (cannot empty bladder, urgent or frequent need to urinate, leaking urine, slow or weak stream), abnormal hole from the vagina into the urinary tract or rectum, vaginal tear or deep cut.

CLICK HERE TO DOWNLOAD BROCHURE

Patients undergoing a hysterectomy who have an undiagnosed cancer may be at risk of having cancer cells spread if the uterus is cut into pieces for removal.

da Vinci Surgical System with Single-Site Technology
State-of-the-art da Vinci uses the latest in surgical and robotics technologies. The da Vinci System’s 3D HD vision system allows surgeons to see key anatomy with depth and clarity. da Vinci also features special wristed instruments that bend and rotate far greater than the human wrist. The da Vinci System translates your surgeon’s hand movements into smaller, more precise movements of tiny instruments inside your body. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision and control.

The da Vinci System has brought minimally invasive surgery to more than 2 million patients worldwide. da Vinci – changing the experience of surgery for people around the world.

* Single-Site technology is only available for benign (non-cancerous) conditions.

 

PN 1006982 Rev. A 06/2014


  1. Cela V, Freschi L, Simi G, Ruggiero M, Tana R, Pluchino N. Robotic single-site hysterectomy: feasibility, learning curve and surgical outcome. Surg Endosc. 2013 Jul;27(7):2638-43. doi: 10.1007/s00464-012-2780-8. Epub 2013 Feb 8.

Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci® Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer towww.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

© 2014 Intuitive Surgical. All rights reserved. All product names are trademarks or registered trademarks of their respective holders.

Content provided by Intuitive Surgical.

HYSTERECTOMY

Hysterectomy Options

Hysterectomy is the surgical removal of the uterus and, if needed, surrounding organs and tissues. Hysterectomy may be recommended for women with fibroid tumors who don’t plan to become pregnant in the future. Each year in the U.S. alone, doctors perform approximately 600,000 hysterectomies, making it the second most common surgical procedure for women.1

Approaches to Hysterectomy

Open Hysterectomy

During an abdominal hysterectomy (open surgery), your uterus is removed through a large open incision. The incision must be large enough for your surgeon to see your organs and fit his/her hands and instruments inside your body.

Minimally Invasive Hysterectomy Options:

Vaginal Hysterectomy – A vaginal hysterectomy is done through a cut in your vagina. The surgeon operates through this incision and closes it with stitches once the uterus is removed.

Traditional Laparoscopy – With traditional laparoscopy, your surgeon operates through a few small incisions in your abdomen using long instruments and a tiny camera. The camera sends images to a monitor in the operating room to guide doctors as they operate. Your uterus can also be removed through a single incision in the belly button.

da Vinci Multi-port Hysterectomy – With the da Vinci Surgical System, your doctor operates through a few small incisions (multi-port surgery) – similar to traditional laparoscopy. The da Vinci System features wristed instruments that bend and rotate far greater than the human wrist. The da Vinci System also features a magnified 3D high-definition vision system that allows surgeons to see key anatomy with depth and clarity. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision, dexterity and control.

da Vinci® Single-Site® Surgery – Your uterus can also be removed through a small incision in your belly button using da Vinci Single-Site Surgery. This technology allows for virtually scarless results. da Vinci Single-Site is performed for benign (non-cancerous) conditions.

da Vinci is a minimally invasive approach that uses the latest in surgical and robotics technologies. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.

da Vinci Hysterectomy is the #1 minimally invasive hysterectomy performed in the U.S.2

CLICK HERE TO DOWNLOAD BROCHURE

Types of Hysterectomy

There are many types of hysterectomy performed, depending on your diagnosis and overall health. All hysterectomies involve removal of the uterus. What can vary are which reproductive organs and tissues may also be removed. Types of hysterectomy include:

  • Partial or subtotal hysterectomy: This procedure, also known as a supracervical hysterectomy, involves removing the uterus, but leaving the cervix intact. This decision is often based upon patient preference.
  • Total hysterectomy: This procedure involves removing the uterus and cervix. The vagina remains entirely intact. This is the most common type of hysterectomy performed.
  • Removal of lymph nodes: For hysterectomies performed for malignant conditions such as uterine, cervical, or ovarian cancer, the surgeon will also remove certain lymph nodes. This procedure is often referred to as a lymph node dissection or lymphadenectomy. Lymph nodes will be removed in certain areas, depending upon the location and extent of cancer. Lymph node removal also helps your surgeon determine the extent or stage of your cancer, and can guide further adjuvant treatment, such as radiation therapy or chemotherapy.
  • Removal of fallopian tubes and ovaries: These organs may or may not be removed during your hysterectomy. This will depend on your condition, age, overall health and personal preference. Removal of the ovaries is called an oophorectomy. Removal of fallopian tubes and ovaries is called a salpingo-oophorectomy.
  • Radical hysterectomy: During this procedure, the uterus and cervix are removed.

PN 1002179 Rev B 06/2014


  1. http://womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.pdf
  2. Inpatient data: Agency for Healthcare, Research and Quality (AHRQ). Outpatient data: Solucient® Database – Truven Health Analytics. da Vinci data: Intuitive Surgical internal estimates.

Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci® Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer towww.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

© 2014 Intuitive Surgical. All rights reserved. All product names are trademarks or registered trademarks of their respective holders.

Content provided by Intuitive Surgical.

MYOMECTOMY

If you’ve been diagnosed with fibroid tumors, your doctor may recommend a myomectomy. With a myomectomy procedure, your surgeon removes the fibroids and not your uterus. If you are considering surgery, ask your doctor about minimally invasive da Vinci Myomectomy.

Why da Vinci Myomectomy?

With the da Vinci System, surgeons operate through a few small incisions instead of a large open incision – similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision, dexterity and control.

As a result of the da Vinci technology, da Vinci Myomectomy offers the following potential benefits compared to traditional open surgery:

  • Less blood loss1,2,3
  • Shorter hospital stay1,2,3,4
  • Less need for narcotic pain medicine4
  • Small incisions for minimal scarring5

 

As a result of the da Vinci technology, da Vinci Myomectomy offers the following potential benefits when compared to traditional laparoscopy:

  • Minimally invasive removal of heavier, more numerous and more difficult to access fibroids1
  • Fewer complications during surgery6

State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. da Vinci – taking surgery beyond the limits of the human hand.

CLICK HERE TO DOWNLOAD BROCHURE

Physicians have used the da Vinci System successfully worldwide in approximately 1.5 million various surgical procedures to date. da Vinci – changing the experience of surgery for people around the world.

Risks & Considerations Related to Myomectomy & da Vinci Surgery

Potential risks of any myomectomy procedure, including da Vinci Surgery include:6

  • Wound infection
  • Injury to nearby organ (bowel)
  • Pelvic abscess

PN 1002186 Rev B 04/2014


    1. Barakat EE, Bedaiwy MA, Zimberg S, Nutter B, Nosseir M, Falcone T. Robotic-assisted, laparoscopic, and abdominal myomectomy: a comparison of surgical outcomes. Obstet Gynecol. 2011 Feb;117(2 Pt 1):256-65.
    2. Ascher-Walsh CJ, Capes TL. Robot-assisted laparoscopic myomectomy is an improvement over laparotomy in women with a limited number of myomas. J Minim Invasive Gynecol. 2010 May-Jun;17(3):306-10. Epub 2010 Mar 19.
    3. Sangha R, Eisenstein D, George A, Munkarah A, Wegienka G. Surgical outcomes for robotic-assisted laparoscopic myomectomy compared to abdominal myomectomy. Journal of Robotic Surgery, Volume 4, Number 4, December 2010 , pp. 229-233(5).
    4. Nash K, Feinglass J, Zei C, Lu G, Mengesha B, Lewicky-Gaupp C, Lin A. Robotic-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparative analysis of surgical outcomes and costs. Arch Gynecol Obstet. 2012 Feb;285(2):435-40. Epub 2011 Jul 22.
    5. Advincula AP, Song A, Burke W, Reynolds RK. Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc.2004 Nov;11(4):511-8 (see figure 2). Alternatively, see Myomectomy Procedure Guide, PN 871798.
    6. Bedient CE, Magrina JF, Noble BN, Kho RM. Comparison of robotic and laparoscopic myomectomy. Am J Obstet Gynecol. 2009 Dec;201(6):566.e1-5. Epub 2009 Aug 15.

Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer towww.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

© 2014 Intuitive Surgical. All rights reserved. All product names are trademarks or registered trademarks of their respective holders.

Content provided by Intuitive Surgical.

ENDOMETRIOSIS RESECTION

If you’ve been diagnosed with endometriosis, your doctor may recommend an endometriosis resection (removal of endometrial implants/uterine lining) or a hysterectomy (removal of the uterus). If you are considering surgery, ask your doctor about minimally invasive da Vinci Surgery.

da Vinci Surgery

With the da Vinci System, surgeons operate through a few small incisions instead of a large open incision – similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision, dexterity and control.

As a result of da Vinci technology, da Vinci Endometriosis Resection offers the following potential benefits, which are similar to those offered by traditional laparoscopy:

  • Low blood loss1
  • Low conversion rate to open surgery1
  • Low rate of complications1
  • Short hospital stay1
  • Small incisions for minimal scarring

da Vinci’s 3D HD vision system allows surgeons to see key anatomy with depth and clarity– critical to removing deep endometrial tissue implants. State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.

CLICK HERE TO DOWNLOAD BROCHURE

Physicians have used the da Vinci System successfully worldwide in approximately 1.5 million various surgical procedures to date. da Vinci is changing the experience of surgery for people around the world.

Risks & Considerations Related to Endometriosis Resection & da Vinci Surgery

Potential risks of any endometriosis resection procedure include:2

  • Wound infection
  • Urinary infection
  • In rare cases, injury to nearby organs (bladder, bowel and ureter)

da Vinci Hysterectomy

If you plan to have a hysterectomy – removal of the uterus – you may be a candidate for da Vinci Hysterectomy. As a result ofda Vinci technology, potential benefits of da Vinci Hysterectomy compared to traditional open surgery include:

  • Less blood loss3
  • Fewer complications3
  • Shorter hospital stay3,4
  • Small incisions for minimal scarring

Potential benefits of da Vinci Hysterectomy compared to traditional laparoscopy include:

  • Less blood loss5
  • Lower conversion rate to open surgery5,6
  • Shorter hospital stay5,7
  • Less need for narcotic pain medicine8,9

State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. da Vinci – taking surgery beyond the limits of the human hand.

Physicians have used the da Vinci System successfully worldwide in approximately 1.6 million various surgical procedures to date. da Vinci is changing the experience of surgery for people around the world.

Risks & Considerations Related to Hysterectomy & da Vinci Surgery

Potential risks of any hysterectomy procedure include:3

  • Separation of the vaginal incision
  • Blocked lung artery
  • Urinary tract injury

PN 1002175 Rev C 01/2014


  1. Nezhat C, Lewis M, Kotikela S, Veeraswamy A, Saadat L, Hajhosseini B, Nezhat C. Robotic versus standard laparoscopy for the treatment of endometriosis. Fertil Steril. 2010 Dec;94(7):2758-60. Epub 2010 May 26.
  2. Endometriosis.org Global forum for news and information. “Surgery”. Available from: http://endometriosis.org/treatments/endometriosis-surgery/
  3. Landeen L, Bell M, Hubert H, Seshadri-Kreaden U, Hassebroek J. A Comparative Study of Four Surgical Approaches for Hysterectomy at a Single Institution: Outcomes and Costs of Robot-Assisted, Laparoscopic, Vaginal, and Abdominal Procedures. Pending publication June 2011, South Dakota Medical Review.
  4. DuBeshter B, Angel C, Toy E, Thomas S, Glantz JC. Current Role of Robotic Hysterectomy. Journal of Gynecologic Surgery. Vol 29 Issue 4: August 2013. 29(4): 174-178. doi:10.1089/gyn.2012.0113.
  5. Payne T. N. and F. R. Dauterive. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. (In this study, surgeons treated patients with benign conditions that included endometriosis resection.) J Minim Invasive Gynecol, 2008;15(3): 286-291.
  6. Patzkowsky KE, As-Sanie S, Smorgick N, Song AH, Advincula AP. Perioperative outcomes of robotic versus laparoscopic hysterectomy for benign disease. JSLS. 2013 Jan-Mar;17(1):100-6. doi: 10.4293/108680812X13517013317914.
  7. Giep BN, Giep HN, Hubert HB. Comparison of minimally invasive surgical approaches for hysterectomy at a community hospital: robotic-assisted laparoscopic hysterectomy, laparoscopic-assisted vaginal hysterectomy and laparoscopic supracervical hysterectomy. J Robot Surg. 2010 Sep;4(3):167-175. Epub 2010 Aug 10.
  8. Shashoua AR, Gill D, Locher SR. Robotic-assisted total laparoscopic hysterectomy versus conventional total laparoscopic hysterectomy. JSLS. 2009 Jul-Sep;13(3):364-9.
  9. Betcher R MD, Chaney P MD, Otey S MD, Wood D DO, Lacy P MD, Lee M RN, Chi G PhD. A Retrospective Analysis of Post Operative Pain in Patients Following da Vinci Robotic Hysterectomy and Total Laparoscopic Hysterectomy. Oral presentation, Presented at: AAGL 2012.

 


da Vinci Surgery with Single-Site® Instruments is cleared for use in gallbladder removal, and for hysterectomy and ovary removal for benign conditions. Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci Surgery, including da Vinci Surgery with Single-Site® Instruments. There may be an increased risk of incision-site hernia with single-incision surgery, including Single-Site surgery with da Vinci.

Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci® Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer towww.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

© 2014 Intuitive Surgical. All rights reserved. All product names are trademarks or registered trademarks of their respective holders.

Content provided by Intuitive Surgical.

PELVIC RECONSTRUCTION

Pelvic Reconstructive Surgery

Approximately fifty percent of women who have experienced childbirth have varying degrees of pelvic organ prolapse that affect the vagina. Some of these conditions can include:

  • Vaginal Prolapse. Where the top of the vagina loses its support and drops, this condition occurs most often with women who have had a hysterectomy. Vaginal Prolapse can cause include difficulty urinating, bowel function, painful intercourse, vaginal pain loss of bladder control and a feeling of heaviness in the vaginal area.
  • Small Bowel Prolapse (Enterocele). A condition when the small bowel presses against and moves the upper wall of the vagina causing a bulge or hernia to form.
  • Anterior Vaginal Prolapse (Cystocele). A bulge or cystocele forms on the front wall of the vagina and causes a loss of support to the bladder that rests on that area of the vagina. Symptoms can include incontinence, a feeling of pelvic heaviness or back pain.
  • Posterior Vaginal Prolapse (Rectocele). A condition when the rectum bulges into or out of the vagina. May cause difficulty with bowel movements.

Proper diagnosis is essential in treating pelvic support conditions. Being open about symptoms with your physician is important in finding the exact cause. Depending upon your symptoms and the type or vaginal prolapse you are diagnosed as having, treatments can include special exercises, lifestyle changes, the use of pessaries, changes in diet and lifestyle, reconstructive surgery and obliterative procedures to narrow and shorten the vagina.

Vaginal Prolapse Treatment

In treating or repairing vaginal prolapsed apical suspensions are used to restore the support of the top of the vagina (vaginal vault). Procedures used include:

  • Abdominal Sacral Colopexy (ASC) – performed through an incision in the abdomen either laparoscopically or robotically, ASC involves the use of graft material to reinforce the walls of the vagina by forming straps that, when attached to the ligaments overlying the sacrum, support and suspend the vagina over the pelvic muscles and backbone.
  • Uteroscral or Sacropinous Ligament Fixation – this procedure involves suspending the vagina to a patient’s own uterosacral ligament or sacrospinous ligaments. Graft material can also be added to improve the durability of the repair.

Small Bowel Prolapse (Enterocele) Treatment

The surgical procedure to correct this condition is called a sacral colpopexy. The surgical procedure uses polypropylene or biologic grafts so as to close over the apex of the vagina and correct the bulge or herniation of the small bowel into the vagina. The procedure approaches the vagina intra-abdominally. It is a complicated procedure in which a Y shaped mesh is positioned over the apex of the vagina and re-suspended to the sacrum.

Anterior Vaginal Prolapse (Cystocele) Treatment

A cystocele repair elevates the anterior vaginal wall back into the body to support the bladder. This can be done either vaginally or through an abdominal approach at the time of a sacral colpopexy. In an anterior colporrhaphy, an incision is made in the front wall of the vagina. The vaginal skin is separated from the bladder wall behind it. The weak or frayed edges of the deep vaginal wall are found and the strong tissue next to edges are sutured to each other lifting the bladder and recreating the strong wall underneath it.

Since this part of the pelvic floor is subjected to significant pressure with each cough or when picking up heavy items, up to one third of women will develop recurrent anterior prolapse after an anterior colporrhaphay. To reduce this recurrence, a surgeon may use graft material over the repair to reinforce it.

Posterior Vaginal Prolapse (Rectocele) Treatment

If muscles at the vaginal opening are stretched or separated at childbirth, this condition can be corrected by a perineorrhaphy. It may also be corrected abdominally during a sacral colpopexy. To correct the vaginal bulge, a surgical procedure called an anterior colporrhaphy is performed to raise the back wall of the vagina back into the body to support the bladder.

A posterior coloporrhaphy is a procedure used to repair the rectal bulge that protrudes through the back wall of the vagina. In this procedure, an incision is made in the back wall of the vagina. The vaginal skin is separated from the rectal wall underneath. Once the weak or frayed edges of the deep vaginal wall tissue are identified, the strong tissue next to edges is sutured to each other to recreate the wall between the rectum and the vagina. Occasionally, a surgeon will use graft material to provide additional strength to the repair.

Sacrocolpopexy

If your symptoms from pelvic prolapse are severe and affect your lifestyle, your doctor may recommend surgery. Prolapse surgery is also known as sacrocolpopexy. During the procedure, mesh is used to hold the affected pelvic organ(s) in their correct natural position. The procedure is not the same was what occurs during transvaginal placement of mesh.

Sacrocolpopexy can also be performed after a hysterectomy and can provide long-term support for the vagina.1

Why da Vinci® Surgery

If you are facing pelvic prolapse surgery, you may be a candidate for da Vinci Sacrocolpopexy. da Vinci surgeons make just a few small incisions instead of a large open incision – similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your doctor to operate with enhanced vision, precision, dexterity and control.

As a result of da Vinci technology, da Vinci Sacrocolpopexy offers the following potential benefits when compared to traditional open surgery:

  • Less blood loss1,2,3
  • Shorter hospital stay1,2,3
  • Small incisions for minimal scarring

As a result of the da Vinci technology, da Vinci Sacrocolpopexy offers the following potential benefits compared to traditional laparoscopy:

  • Shorter operation4
  • Less blood loss4
  • Shorter duration with catheter4

Additional potential benefits of da Vinci Sacrocolpopexy include:

  • Low rate of complications5,6
  • High sexual function5
  • Improved urinary, bowel, and pelvic symptoms5

State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. da Vinci – taking surgery beyond the limits of the human hand.

CLICK HERE TO DOWNLOAD BROCHURE

Physicians have used the da Vinci System successfully worldwide in approximately 1.5 million various surgical procedures to date. da Vinci is changing the experience of surgery for people around the world.

Risks & Considerations Related to Sacrocolpopexy & da Vinci Surgery

Potential risks of any sacrocolpopexy procedure, including da Vinci Surgery, include:

  • Bowel blockage2
  • Painful urination4
  • Urinary infection4

PN 1002187 Rev B 01/2014


  1. Geller EJ, Siddiqui NY, Wu JM, Visco AG. Short-term outcomes of robotic sacrocolpopexy compared with abdominal sacrocolpopexy. Obstetrics & Gynecology. 2008;112:1201–6.
  2. Siddiqui NY, Geller EJ, Visco AG. Symptomatic and anatomic 1-year outcomes after robotic and abdominal sacrocolpopexy. Am J Obstet Gynecol. 2012 May;206(5):435.e1-5. Epub 2012 Feb 1.
  3. Hoyte L, Rabbanifard R, Mezzich J, Bassaly R, Downes K. Cost analysis of open versus robotic-assisted sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2012 Nov-Dec;18(6):335-9. doi: 10.1097/SPV.0b013e318270ade3.
  4. Seror J, Yates DR, Seringe E, Vaessen C, Bitker MO, Chartier-Kastler E, Rouprêt M. Prospective comparison of short-term functional outcomes obtained after pure laparoscopic and robot-assisted laparoscopic sacrocolpopexy. World J Urol. 2012 Jun;30(3):393-8. Epub 2011 Aug 20.
  5. Geller EJ, Parnell BA, Dunivan GC. Pelvic floor function before and after robotic sacrocolpopexy: one-year outcomes. J Minim Invasive Gynecol. 2011 May-Jun;18(3):322-7. Epub 2011 Apr 1.
  6. Elliott DS, Krambeck AE, Chow GK. Long-term results of robotic assisted laparoscopic sacrocolpopexy for the treatment of high grade vaginal vault prolapse. J Urol. 2006 Aug;176(2):655-9.

Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer towww.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

© 2014 Intuitive Surgical. All rights reserved. All product names are trademarks or registered trademarks of their respective holders.

Content provided by Intuitive Surgical.