El Camino Women’s Medical Group offers the latest Minimally Invasive Solutions for gynecologic problems.   Drs. Amy Teng, Erika Balassiano, and Pooja Gupta, all members of AAGL (American Association of Gynecologic Laparoscopy) are highly trained and experienced in the field of Minimally Invasive Gynecgologic Surgery.   Dr. Erika Balassiano is also a graduate of the Minimally Invasive Gynecologic Surgery Fellowship at Stanford University, under the supervision of world-renowned Dr. Camran Nezhat.

Servicing Mountain View, Los Altos, Los Altos Hills, Atherton, Palo Alto, Redwood City, Burlingame, Saratoga, Cupertino, Sunnyvale, Los Gatos, Campbell, San Jose, Santa Clara, Silicon Valley, Milpitas, South Bay, East Bay, North Bay.

Hysterectomy for Benign Conditions

Surgical  Incision Comparison

Open Surgery                                            Traditional  Laparoscopic Hysterectomy

da Vinci® Hysterectomy (Multi-port)

da Vinci Single-Site® Hysterectomy or Traditional Laparoscopic Single Incision Hysterectomy

da Vinci Single-Site instruments inserted through one incision in the bellybutton

5 Minutes After Surgery (Real patient photo,

da Vinci Single-Site Hysterectomy)**

**Results, including cosmetic results, may vary.

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. Please also refer to www.daVinciSurgery.com/Safety for Important Safety Information.

Potential Patient Benefits of

da  Vinci® Hysterectomy

for Benign Conditions (multi-port)

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

• Reduced complication rate1, 2, 3, 4
• Reduced length of hospital stay1, 2, 3, 4, 5

•   Reduced blood loss and less likelihood for transfusion1, 3, 4, 5

• Reduced readmission rate4, 5

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

• Reduced complication rate4, 6
• Reduced length of hospital stay1, 2, 4, 5, 6, 7, 8
• Reduced blood loss2, 5, 8

•   Reduced chance of procedure converting to an abdominal procedure2, 5, 8

• Less likelihood of blood transfusion4, 9

As a result of da Vinci® technology, da Vinci® Hysterectomy offers the following potential benefits as compared to vaginal surgery:

• Reduced length of hospital stay2, 4, 5
• Reduced blood loss2, 5

What is da Vinci Surgery?

A Minimally Invasive Surgical Option

Using the da Vinci Surgical System, surgeons operate through just a few small cuts (incisions). The da Vinci System features a magnified 3D high-definition vision system and tiny 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.

Since  2000,  over  3  million  patients  have  had  minimally invasive

da Vinci Surgery worldwide.

Potential Risks Related to Hysterectomy, including

da Vinci Hysterectomy:

Hysterectomy, Benign (removal of the uterus and possibly nearby organs): injury to the ureters (the ureters drain urine from the kidney into the bladder), vaginal cuff problems (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. Uterine tissue may contain unsuspected cancer. The cutting or morcellation of uterine tissue during surgery may spread cancer, and decrease the long-term survival of patients.

Learn more at www.daVinciSurgery.com

Important Safety Information

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 to www.davincisurgery.com/safety and www.intuitivesurgical.com/safety.

REFERENCES

1. Ho C, Tsakonas E, Tran K, Cimon K, Severn M, Mierzwinski-Urban M, Corcos J, Pautler “Robot-Assisted Surgery Compared with Open Surgery and Laparoscopic Surgery: Clinical Effectiveness and Economic Analyses.” Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2011 Sep.
2. Landeen, Laurie , MD, MBA, Maria C. Bell, MD, MPH, Helen B. Hubert, MPH, PhD, Larissa Y. Bennis, MD, Siri S. Knutsten-Larsen, MD, and Usha Seshari-Kreaden, MSc. “Clinical and Cost Comparisons for Hysterectomy via Abdominal, Standard Laparoscopic, Vaginal and Robot-assisted Approaches.” South Dakota Medicine 64.6 (2011): 197-209. Print.
3. Geppert B, Lönnerfors C, Persson “Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery.” Acta Obstet Gynecol Scand. 90.11 (2011): 1210-1217. doi: 10.1111/j.1600-0412.2011.01253.x. Epub.
4. Lim, Peter , John T. Crane, Eric J. English, Richard W. Farnam, Devin M. Garza, Marc L. Winter, and Jerry L. Rozeboom. “Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications.” International Journal of Gynecology & Obstetrics 133.3 (2016): 359–364. Ref.
5. Martino, Martin , MD, Elizabeth A. Berger, DO, Jeffrey T. McFetridge, MD, Jocelyn Shubella, BS, Gabrielle Gosciniak, BA, Taylor Wejkszner, BA, Gregory F. Kainz, DO, Jeremy Patriarco, BS, M. B. Thomas, MD, and Richard Boulay, MD. “A Comparison of Quality Outcome Measures in Patients Having a Hysterectomy for Benign Disease: Robotic vs. Non-robotic Approaches.” Journal of Minimally Invasive Gynecology 21.3 (2014): 389-93. Web.
6. Scandola, Michele, Lorenzo Grespan, Marco Vicentini, and Paolo “Robot-Assisted Laparoscopic Hysterectomy vs Traditional Laparoscopic Hysterectomy: Five Metaanalyses.” Journal of Minimally Invasive Gynecology 18.6 (2011): 705-15. Print.
7. Wright, Jason , Cande V. Ananth, Sharyn N. Lewin, William M. Burke, Yu-Shiang Lu, Alfred I. Neugut, Thomas J. Herzog, and Dawn L. Hershman. “Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease.” Jama 309.7 (2013): 689-98. Print.
8. Orady, Mona, Alexander Hrynewych, Karim Nawfal, and Ganesa Wegienka. “Comparison of Robotic-Assisted Hysterectomy to Other Minimally Invasive Approaches.” JSLS, Journal of the Society of Laparoendoscopic Surgeons 16.4 (2012): 542-48. Print.
9. Rosero, Eric , Kimberly A. Kho, Girish P. Joshi, Martin Giesecke, and Joseph I. Schaffer. “Comparison of Robotic and Laparoscopic Hysterectomy for Benign Gynecologic Disease.” Obstetrics & Gynecology 122.4 (2013): 778-86. Print.

© 2016 Intuitive Surgical, Inc. All rights reserved. Product names are trademarks or registered trademarks of their respective holders. PN 1016706 Rev B 09/16

El Camino Women’s Medical Group offers the latest Minimally Invasive Solutions for gynecologic problems.   Drs. Amy Teng, Erika Balassiano, and Pooja Gupta, all members of AAGL (American Association of Gynecologic Laparoscopy) are highly trained and experienced in the field of Minimally Invasive Gynecgologic Surgery.   Dr. Erika Balassiano is also a graduate of the Minimally Invasive Gynecologic Surgery Fellowship at Stanford University, under the supervision of world-renowned Dr. Camran Nezhat.

Servicing Mountain View, Los Altos, Los Altos Hills, Atherton, Palo Alto, Redwood City, Burlingame, Saratoga, Cupertino, Sunnyvale, Los Gatos, Campbell, San Jose, Santa Clara, Silicon Valley, Milpitas, South Bay, East Bay, North Bay.