This minimally-invasive procedure, performed with the da Vinci Surgical System, is used to restore a uterus that has fallen into or pushed through the vagina. During this procedure, a surgical mesh support is inserted and attached to lift the uterus into its normal position.
In preparation for the procedure, the patient is anesthetized and positioned on an adjustable platform. This gives the robotic surgical arms full access to the abdomen. The skin on the abdomen is cleansed. A thin needle is passed through the abdominal wall into the abdominal cavity. This needle is used to inflate the abdomen with carbon dioxide gas. This inflation separates the organs to allow the surgeon to see the organs clearly. It creates working space for the surgical instruments.
The surgeon's assistant inserts a manipulator into the vagina. This allows the vagina to be moved and positioned as needed. A blunt device may be inserted into the rectum to protect the bowel during the surgery.
Five small incisions are created on the abdomen. The surgery will be performed through these tiny port sites, rather than the large incision traditionally used for open surgery. This minimally-invasive approach minimizes pain, scarring, risk of infection, and recovery time.
The endoscopic camera and various surgical instruments are guided through the ports. These instruments will be held securely by the robotic arms of the da Vinci system. The surgeon takes a seat at the console to perform the procedure. A video monitor in the console, which is linked to the endoscope, allows the surgeon to view the surgical site in 3D. The surgeon can precisely control the instruments during the surgery.
A surgical mesh is inserted and sutured to the front and rear of the cervix. The uterus is carefully lifted, and the mesh is sutured to a strong ligament overlying the sacral bone. The mesh will suspend the uterus and keep it in its normal position.
When the procedure is complete, the gas and the instruments are removed from the abdomen. The incisions are closed and bandaged. During the healing process, fibers from the ligament will grow through the mesh, strengthening the support system.