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DA VINCI ROBOT-ASSISTED HYSTERECTOMY AND LYMPH NODE DISSECTION - page 3 / 17

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switch-over of feeling how strong the robot is that it's a lot stronger than you are comes relatively quickly. 00:06:28 TODD D. TILLMANNS, M.D.: Yeah, I would agree completely, and I think the interesting part about the camera, when you look at the camera itself there's actually two lenses and that mimics your own eyes so it really enhances the view that you can see. Right now, Dr. Lowe is dissecting beneath the ovary there as he anticipates freeing up this tissue even further. 00:06:52 DILJEET K. SINGH, M.D.: So for the people watching who don't know about endometrial cancer, so part of the surgery is removing the uterus, the cervix, the fallopian tubes and ovaries, and then the lymph nodes. All of those things help up understand what the stage of the cancer is, how far it spread, and then gives us the things we need to do to be able to treat the cancer if any more treatment is needed. Often times, though, this surgery itself sort of serves as all the treatment we need for endometrial cancer. 00:07:18 TODD D. TILLMANNS, M.D.: Right now, what he's doing is he's freeing up what's called the infundibular pelvic ligament, which is the blood supply to the ovaries and the fallopian tubes and the top of the uterus. This device right here is going to coagulate those blood vessels, sealing them, and then they'll be able to cut through them safely without losing really any blood and I think that's another large advantage, Dr. Singh. You can maybe elaborate on that, the blood loss compared to open procedures or standard procedures. 00:07:50 DILJEET K. SINGH, M.D.: Yeah, I'll be honest. When Dr. Lowe first joined us and talked about this, I wasn't a believer. It's until you start operating and you sort of have the excellent visualization that you do, really every small capillary that, I'll be honest, we probably don't see very well when we're doing open surgery, but with the ten times magnification and the 3-D view that we get, we clearly see things that we can cauterize. Similarly, I think that one of the reasons the long-term complications of lymph node dissection is less when we do surgery robotically is for the same reason. We're able to coagulate small, small, they're called lymphatics, and so decreased chances of lymphoceles and lymphatic [unclear] in a way that we can't necessarily when we do the surgery open. 00:08:35 TODD D. TILLMANNS, M.D.: The procedure that Dr. Lowe is doing right now today, he is one of the authors on a recent study that was just presented at a national meeting and the average blood loss for this exact procedure, including the lymph node removal and everything, was about six tablespoons of blood, which is much less than we typically get with open procedures. 00:08:56 DILJEET K. SINGH, M.D.: The average described in a standard hysterectomy with lymph nodes is about a Coke can of blood loss. The difference between that is substantial. In the long run and when we think about the other complications such as bowel, and how long it takes to wake up, other damage to the neighboring organs. All of those things are substantially decreased, probably because of a lack of exposure, not being touched, not being handled, and so recovering much more quickly. 00:09:26 TODD D. TILLMANNS, M.D.: Exactly. 00:09:27

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