Renee Burcin never missed an annual exam and not once had her Pap come back as abnormal, so her cancer diagnosis — and news that she would need a hysterectomy — came as a shock.
“I have been extremely healthy all my life,” said Burcin, 46, of Olney. “It happened so quick. It was so not what we were expecting in any way.”
Her doctor at the time advised her to have a radical hysterectomy, which involves an incision in the abdomen to remove the uterus.
But something about the recommendation left her unsure, and she began to ask around. A friend pointed her to Johns Hopkins and Dr. Robert Bristow, who offered an alternative: Minimally invasive surgery using a robot.
In May, she opted for this procedure, wanting to avoid weeks of recovery time and a large scar across her stomach.
“I was able to go home the next day and I was back at work in less than three weeks,” said Burcin, who described her scars as “five incisions that looks like mosquito bites.”
Bristow, director of the Kelly Gynecologic Oncology Service at the Johns Hopkins Ovarian Cancer Center, said using a robot in the surgery for many gynecologic cancers allows the doctor better movement and sight during surgery and less pain for the patient.
“It’s still pretty new,” Bristow said of the technique. “It’s been in this field for the last three or four years.”
Bristow took interest in it about a year and a half ago, and now about 75 percent to 80 percent of the hysterectomies done there for cervical and uterine cancer use this approach, he said.
The minimally invasive technique using a robot is an alternative to laproscopic surgery, which is similar and uses small incisions and tools mounted on long sticks, or traditional abdominal surgery requiring a large incision.
Most of the 600,000 hysterectomies in the United States each year are done with the traditional large incisions, said Dr. David Zisow, a gynecologist and associate chief of minimally invasive surgery at Northwest Hospital Center in Randallstown and an early adopter of what is called straight stick laproscopic surgery. But most of the hysterectomies could be done with minimally invasive techniques.
However, not enough doctors are trained in these methods, said Zisow, who teaches and mentors doctors in the minimally invasive techniques.
Robot-assisted procedures are even more rare because of the cost, he said. The equipment alone can cost $1.5 million, plus annual maintenance fees, he said.
For hysterectomies as treatment for more common ailments such as an enlarged uterus, the robotic approach is “overkill,” he said, but the approach may be more appropriate for cervical and uterine cancers.
“Many of the leaders in the field of robotic surgery are in gynecologic cancer,” Zisow said. “That may be the niche that is appropriate, but that won’t be your vast majority of patients.”
