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the aorta. Here you can see the sigmoid colon. What that's going to allow us to do is mobilize the ovarian vessels up and away from our ureter, which is right here under this little area of tissue and under this little area of fat right there, which will then allow us to mobilize the ureter this way, laterally, and then to be able to remove these lymph nodes, and then as we extend up higher along the aorta as well as the vena cava. So, and I think Dr. Tillmanns and Dr. Singh both would attest to setting the spaces up, whether you're probably doing an open case or minimally invasive procedure, it really facilitates those dissections later on in the case. So to talk a little bit about setting up the patient set-up, going to sleep, putting in the trocars and dock time. We've had our robotic surgery program here at Northwestern for exactly 12 months and what we've seen over that point in time is pretty much a growth in the program to where we have dedicated surgical teams. We have two to three dedicated surgical teams where the scrubs and the circulators have been trained extensively in the robotic surgery and the robotic procedures. They are very interchangeable and they are all very good. So I think we're very fortunate in having them in our program. In addition, we have our fellows. We have a fellowship program that trains fellows in gynecologic oncology. Our fellows have participated in these cases since the beginning last summer and they've gained experience and maybe a little bit later on we can talk to Dr. Hoekstra who is our third year fellow, will be finishing next year and she has had a very good experience in my opinion in relation to robotic surgery, as well as other minimally invasive surgery. One of the things I think's really important when you talk about robotics in minimally invasive surgery is that a year ago we treated approximately five percent of our patients with endometrial, early stage endometrial, or early stage cervical cancer with conventional laparoscopy. What we've done is we've collected a perspective database over the last 12 months and we've recently reported some of our data at the interval of six months at the Western Association of Gynecologic Oncologists. So what we found is that we've been able to increase the utilization of a minimally invasive approach for endometrial cancer up to 50 percent from 5 to 10 percent and for cervical cancer up to 50 percent. So that's a really dramatic change in our program and also the way that we're treating patients with a minimally invasive approach. And we were doing laparoscopy before we instituted our robotic program last summer and so it has made a difference in our practice and it has made a difference in the way that we're caring for our patients and I think I heard Diljeet talking hospital stay for the patients since we've instituted this program and it's really been amazing when we look at the endometrial cancer patients specifically over six months. In the preceding six months before we started the robotics program, what we found was that the total number of hospital stays for all of the patients who had surgery for endometrial cancer was 206 days and that was between January and June the 30th of 2007. What we saw between July 1st and December of 2007 was the total number of hospital stays for the same number of patients having surgery for endometrial cancer was 96 days. So we basically cut the hospital stay in half for our patients. To sort of orient everyone where we are in the case right now, this is basically our uterine artery, uterine vein, okay. We sort of skeletonize the uterine vessels here. That's a fairly standard portion of a hysterectomy. We're going to divide these vessels on this side in just a minute and we'll also facilitate finishing mobilizing the bladder, which is here, as well as here, away from the anterior surface of the cervix and the upper vagina. Now Margarita, what I want you to do is just bring the uterus back just a little bit, little more retroversion, and what I'm going to do -- actually, nope. Come back a little bit. Come back towards me, Margarita. 00:17:37 DILJEET K. SINGH, M.D.: Maybe we can take this little break in the action as a time to answer some of our email questions.

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