Transcription:
Breakthroughs in Minimally Invasive Surgeries for Women’s Health

Deborah Howell (Host): Hello and welcome to the show. You’re listening to Weekly Dose of Wellness brought to you by MemorialCare Health System. I’m Deborah Howell and today’s guest is Dr. Marc Winter, medical director of robotic surgery at Saddleback Memorial Medical Center in Laguna Hills. With more than 20 years of experience performing gynecological surgeries, Dr. Winter has focused on developing and offering minimally invasive procedures. Dr. Winter completed his residency training at the University of California Irvine, College of Medicine, where he is currently an assistant clinical professor. Welcome, Dr. Winter. Dr. Marc Winter (Guest): Thank you for having me. Deborah: Good morning to you. Today, on the show, we’re going to be talking about breakthroughs in minimally invasive surgeries for women’s health and hopefully hear an announcement about a major technological breakthrough, as well. First of all doctor, in which areas of women’s health do you specialize? Dr. Winter: Well, I’m a gynecologist. I specialize in women’s care, in general, but specifically minimally invasive surgery, which I’ve been doing for a long time, and over the last two years, more specifically, robotics surgery. At Saddleback Hospital, we’ve developed a very robust program and have a lot going on within that realm. Deborah: Speaking of robustness, now I understand that Saddleback Memorial Medical Center might have had a couple of breakthroughs in surgical techniques. Maybe you could speak to that. Dr. Winter: Sure. Well, as I’ve mentioned, we’ve been performing robotics surgery for about two and a half years. One of the things we’ve tried to do is decrease the amount of incisions, not just for cosmetics purposes—obviously, that’s a big deal—but also less incisions, less pain, less issues that could happen. So, people have been trying to do surgery with one incision for a while, but from a technical point of view, it’s much more difficult. Your arms have to cross to get the right angles to be able to operate properly. [Sub-mimic] robot came up with a way to do single-site surgeries, so just one incision, where your right hand, as it crosses over, is crossed on a robot. So, right is right; left if left. It makes sense as you’re operating. We were the first in California, actually the first in the West Coast, to perform a robotic single-site hysterectomy. Deborah: For women, this is very, very good news, especially women in that area. Dr. Winter: It’s really exciting for me, because I see this as the tip of the iceberg where things are going. Technology is going to get better and better, make it more applicable for more types of procedures. As technology gets better, again it’s not just better cosmesis; we’re getting less complications, better results for our patients. Deborah: Love it. Dr. Winter: We’re very excited about that. Deborah: Now, let’s take a step back just for a minute. When considering a hysterectomy, what surgery options do women really have at this point? Dr. Winter: That’s a great question because depending on your circumstances or who you’re going to see as a physician, sometimes we’re guilty, in general, of not going over every single option in detail. There are the traditional hysterectomy, your “mother’s hysterectomy” with a large incision like a C-section type of incision, there are regular laparoscopy, which the idea is small incisions, quicker recovery, faster return to normal activity, less pain; and then, robotics surgery, of course, now there’s single site. Some procedures can be performed vaginally, which is also a good alternative and quick recovery as well. But, it’s limited; the problem with vaginal surgery is limited as to what most doctors are comfortable being able to perform that way. With robotic surgery, we can take care of almost everything. Deborah: Dr. Winter, do you perform all three types of surgeries yourself? Dr. Winter: In my career, I’ve performed everything. Occasionally, I’ll perform abdominal procedures or the traditional procedures when necessary, regular laparoscopy, although for my hysterectomies, I prefer most of the time the robotic approach. Deborah: Sure. Now, let’s talk a little bit more about that single-site robot-assisted hysterectomy. Compared to a traditional hysterectomy, or even other conventionally, minimally-invasive procedure, what makes it so brilliant? Dr. Winter: Well, single-site is literally on small incision. That incision is about an inch in size, and through that incision, we are able to do a complete hysterectomy, which to me, it seems like technology has advanced so quickly, I’m a little awed by this as well. Deborah: That’s why I had to ask you again. I’m like, “Really?” Dr. Winter: Like I said, cosmetically, we can hide it; you almost can’t tell you had surgery. Like I said, the early results are our patients are doing very well. Deborah: I had the laparoscopy myself for a partial, and I call it my drive-by hysterectomy. I mean, it was amazing compared to my mother, which she had had to go through in her day. Dr. Winter: Exactly, and again, things continue to evolve in a good way. Deborah: Well, okay. Now, I want to ask you what factors to consider when recommending the best approach for your patients. You said you have done in recent history traditional hysterectomy. So what do you take a look at? Dr. Winter: Well, again, I think the reasons to do a traditional hysterectomy these days are rare. So, if somebody is advising you to have a traditional hysterectomy, I think, do your homework. Don’t be shy about getting a second opinion. Go, see somebody who is experienced in all methods of minimally invasive surgery, so that you really can get a different perspective and make an educated decision. Deborah: What are some of the symptoms a woman might have prior to having a hysterectomy? Dr. Winter: The most common things are fibroids, which are smooth muscle tumors or growth within the uterus that can cause pain and pressure; sometimes, abnormal bleeding is a very frequent reason. And then, the other reason sometimes, I take care of women that have prolapse problems, where things are falling down and need to be reconstructed or pulled back up to their normal position. Deborah: Okay. Along with this, can it come bloating and pain? Dr. Winter: Yes. I mean, I think, if a woman is having any kind of abnormal issue, pain, bloating, something that shouldn’t be ignored, something that could be an early sign that there’s something going on inside and should be checked out by a physician. Deborah: That’s just general common sense. It anything seems weird with your body, go see your doctor. Dr. Winter: Absolutely. Deborah: Don’t think it will just go away. Dr. Winter: Listen to your body and just make sure everything’s okay. That’ll keep you in good stead. Deborah: Just a little bit about the robotics surgery at the center, if you would. Dr. Winter: Sure. A little over a year ago, Saddleback Memorial became the only Robotics Surgery Epicenter for Gynecology in Orange in LA County. We are one of the only 22 centers of teaching in benign gynecology in the country. Based on the hospital, our surgical team, the efficiency of the team, in addition to my experience, it all went together in us being tapped, so to speak, by Intuitive, the company that makes the robot. They’re very selective as far as taking centers that have “everything together,” where they can be a teaching center. Basically, on a weekly basis, I have people coming from all over the country to look over my shoulder and see what we’re doing and observe the latest technique, so to speak, in robotics surgery. It’s been a great thing for us, and a great thing for me. I enjoy teaching and showing people better ways to do things, and obviously, it keeps you on your toes, as well, which I love. Deborah: The more techniques and the more surgeries you do, the more you learn as well. Dr. Winter: Absolutely. There’s always something to learn. Deborah: Robotics Surgery Epicenter. I’m wondering what the difference between a center and an epicenter is. Dr. Winter: Well, yes. That’s just the term within the robotics surgery world. Those are the centers where teaching goes on. Deborah: What else should we know as women as we age and go through life and go through the changes? Dr. Winter: Well, I think seeing your doctor on a regular basis, communicating whatever issues you have with your physician. The world is changing quickly, so it’s exciting. Your doctor can educate you; as well as on the internet, there’s a lot out there to see. There are talks locally, where people can learn about things and different issues. Within our office, occasionally I’ll talk about surgery. One of my other partners does a regular talk on menopause and the changes women go through. One of my other partners gives the talk on before you get pregnant. There are a lot of educational opportunities around for people if they’re interested in improving their health. Deborah: Dr. Marc Winter, I want to thank you so much for finding the time to talk to us today about these breakthroughs in women’s health. It is an exciting time to be a woman. Thank you so much for being on this show. Dr. Winter: You’re welcome. It’s really my pleasure and thank you for having me. Deborah: And now, I’ll let you go back to helping your many women patients who are patiently awaiting you. Dr. Winter: I’ll tell you. Yes, they are. Deborah: I’m Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness brought to you by MemorialCare Health System. Have a great day.