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The Use of Robotic Surgery in the Management of Gynecologic Cancers

Every year, more than 60,000 women in the United States are diagnosed with endometrial/uterine cancer. At City of Hope, we treat you as a valued individual. Our entire uterine/endometrial cancer team works together to bring you advanced surgery, chemotherapy, radiation and supportive care options that will deliver the best outcome for you.

On this segment, Mehdi M. Kebria, M.D. discusses the use of robotic surgery in management of gynecologic cancers.
The Use of Robotic Surgery in the Management of Gynecologic Cancers
Featured Speaker:
Mehdi M. Kebria, MD
Mehdi M. Kebria, MD, is an assistant clinical professor in the Division of Surgical Oncology, Department of Gynecologic Oncology and and a gynecologic oncologist at City of Hope.

His specialty is Robotic Surgery and Cytoreductive Surgery with HIPEC.

He grew up in a family of physicians and is proud to carry on that tradition. He is board-certified in obstetrics and gynecology and specializes in ovarian, cervical, vulvar and uterine cancers.

Learn more about Mehdi M. Kebria, MD
Transcription:
The Use of Robotic Surgery in the Management of Gynecologic Cancers

Melanie Cole (Host): Every year, more than 60,000 women in the United States are diagnosed with endometrial or uterine cancers. My guest today is Dr. Mehdi Kebria. He’s an Assistant Clinical Professor in the Division of Surgical Oncology in the Department of Gynecologic Oncology at City of Hope. Welcome to the show, Dr. Kebria. When we’re talking about gynecologic cancers, what are we really talking about? What type of cancers?

Dr. Mehdi Kebria (Guest): When we talk about gynecologic cancers there are several cancers of female organs that are basically included in gynecologic cancer. The most common cancer that we deal with as gynecologic oncologists are uterine cancers, followed by ovarian cancers, and then cervical cancers and then vulvar cancers, vaginal cancers, and gestational trophoblastic disease. These are the majority of the diseases that we deal with as gynecologic oncologists.

Melanie: So when we’re talking about treatments that are involved and if surgical intervention is involved, what does that usually entail and tell us about how robotic surgery is involved in this.

Dr. Kebria: As gynecologic oncologists, we perform a great deal of robotic surgery. The majority of our surgeries are minimally invasive surgery, and basically one of the advantages of robotic surgery is the fact that we can perform the surgery that previously has been done in an open fashion or invasive fashion. Currently, we do these procedures as a minimally invasive fashion. We use smaller incisions and more sophisticated instruments and tools to perform these surgeries. Robotic surgery gives us the advantage of using a dual camera. It gives us clearer images – high definition images and a 3D view of the surgical field. It gives us depth perception and improves the visualization of the surgical field. Also, it gives us instruments that are articulating. They have precise articulating instruments, and it allows us to perform complex procedures in a minimally invasive fashion.

Melanie: What are the benefits for the patient for this type of robotic surgery?

Dr. Kebria: The main advantage for the patients are that the incisions are smaller, about eight millimeters in size, each incision and there’s minimal tissue trauma to the patient. There is faster recovery for the patients, and usually, they experience less pain. There are several studies that have compared the outcome of patients with minimally invasive surgeries, or robotic surgeries to traditional open surgeries. Most of those studies, the majority of them are showing that you can perform these surgeries in a minimally invasive fashion while you have similar cancer outcomes, but less risk of complications, less risk of pain, and the patients end up recovering faster.

Melanie: Are there some people that might not be a candidate for this type of robotic surgery for gynecologic cancers?

Dr. Kebria: There are some groups of patients that are not candidates for minimally invasive surgery, and those are patients with advanced cancer. Women who have cancers of the ovary that are advanced, they need an open procedure because the extent of disease is in a way that minimally invasive surgery is not going to be able to remove all of the disease basically. We reserve minimally invasive surgeries for mostly patients with endometrial cancers, cervical cancers and early stage ovarian cancer.

Melanie: So what would you tell a patient to look for when choosing a surgeon to perform this type of robotic surgery?

Dr. Kebria: I think experience is important. I think, like many procedures, you would want to be operated on by a surgeon that has good experience in this field. They have to perform the majority of their surgeries in this way, in a minimally invasive fashion, or robotic surgery, in order to be able to safely perform those surgeries for the patients. Basically, the FDA approved this robotic platform for gynecologic surgery back in 2005, and since then we’ve come a long way, and I can tell you that the majority of the procedures in this field are currently done robotic. There was recently a new development in the field of robotic surgery that includes a single site operation basically. We perform the robotic surgery through one, single incision that’s usually at the level of the umbilicus and that gives a better cosmetic result to the patient. There’s a lot of new developments and studies going on in this area.

Melanie: And how do you see robotic surgery changing in the next several years? What’s exciting at City of Hope? What are you doing?

Dr. Kebria: City of Hope basically has adopted this robotic technology very early on, and they’ve been doing these procedures here at City of Hope for several years now. The majority of our procedures for endometrial cancer is currently done in a robotic manner. We have done some research in this field. There is a lot of new developments, including what I mentioned earlier about the development of a single site robotic surgery at City of Hope. We are hoping that in the future we can use robotic surgery also for some other procedures such as hyperthermic intraperitoneal chemotherapy for patients with ovarian cancer also.

Melanie: So then wrap it up for us Dr. Kebria, if you would, with your best advice for women that are considering all of their options if they’ve been diagnosed with a gynecologic cancer.

Dr. Kebria: Most importantly I would suggest that they should seek medical care from a specialist in this field. Unfortunately, there’s still a lot of women who are diagnosed with gynecologic cancer who are currently in the community or seen by physicians who are not specialized in gynecologic oncology. There are several papers and studies that have shown patients’ outcomes are better if they are treated by a specialized surgeon, so I do advise them to seek care from a gynecologic oncologist basically.

Melanie: Thank you, so much, for being with us today, Doctor. It’s great information. You’re listening to City of Hope Radio, and for more information, you can go to CityofHope.org, that’s CityofHope.org. This is Melanie Cole. Thanks, so much, for listening.