Gynecologist removes ovaries through patient's belly button

Jul 24 2007

Using a new technique developed at Drexel University College of Medicine in Philadelphia, Stephanie A. King, M.D., Associate Professor and Chief of Gynecologic Oncology, removed a woman's ovaries through a single incision in the patient's belly button.

The single port access (SPA) surgery was performed using new high dexterity instrumentation. The entire procedure, believed to be the world's first SPA bilateral oopherectomy, left the patient with a hidden scar in her belly button.

The SPA technique used by Dr. King was developed by Paul G. Curcillo, II, M.D., Vice Chairman of Surgery and Director of Robotic and Minimally Invasive Surgery at Drexel University College of Medicine. Dr. Curcillo has already completed more than 15 procedures using this technique, including six gallbladder removals, and several hernia and stomach surgeries. This is the first time the technique has been used for gynecologic surgery.

“Dr. King's use of the SPA technique to perform a bilateral oopherectomy clearly demonstrates that this new platform of laparoscopy can be applied across surgical fields,” said Dr. Curcillo. “This now expands the benefits of hidden-scar surgery to gynecology patients.”

The patient, a 54-year-old woman, experienced minimal discomfort and has a barely visible scar compared to traditional laparoscopic oopherectomy (ovary removal) requiring three to four incisions - one in the belly button, and two to three others elsewhere on the abdominal wall, which leave obvious scarring.

“To be able to incorporate this new technique and instrumentation into gynecologic surgery is a wonderful benefit to the patient, both in lessening discomfort and hastening recovery, not to mention the hidden scar,” said Dr. King. “It will decrease the number of incisions required in routine gynecologic laparoscopy, as well as allow us to do more advanced gynecologic procedures using fewer incisions.”

Dr. King was able to perform the single port access (SPA) surgery with a newly developed set of high dexterity instrumentation known as RealHand. RealHand laparoscopic instruments are engineered by Novare Surgical Systems, Inc. of Cupertino, California (http://www.novaresurgical.com). According to the company, RealHand instruments are the first full range of motion hand-held laparoscopic instruments designed to mirror the surgeon's hand direction with the added benefit of tactile feedback. As such, when the surgeon's hand moves in one direction, the tip of the instrument exactly follows.

Dr. King's SPA surgery continues the use of this groundbreaking technique at Drexel, and follows recent announcements elsewhere of other types of “natural orifice” (NOTES) procedures, in which surgeons enter through the mouth, rectum, or vagina in an attempt to minimize scarring and port access through the abdomen. Most of these procedures require extensive training and introduce the possibility of added complications.

“The benefit to our technique and the new high dexterity instrumentation is that it can be easily applied by all general laparoscopic surgeons and gynecologists with minimal additional training,” said Dr. Curcillo, who will be running training labs at Drexel University College of Medicine attended by surgeons from around the country. “I believe this will truly revolutionize the way laparoscopic surgery is performed.”