By: Beth Walsh for Fibroids1A 54-year-old patient recently had both of her ovaries removed through a single incision in her belly button – the first single port access (SPA) bilateral oophorectomy. Before this breakthrough, ovaries could be removed through minimally invasive laparoscopic surgery – but it required three or four incisions in the abdomen.
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Unilateral oophorectomy is the removal of an ovary. Bilateral oopherectomy is the removal of both ovaries. When both ovaries are removed, a woman will experience instant and irreversible menopause.
Oophorectomy is used to correct a number of conditions that involve the ovaries, including benign and malignant ovarian cysts and tumors. In women with recurrent cancer or endometriosis, oophorectomy is performed to stop the production of hormones that aggravate the condition. Breast cancer, as well, may be dependent on hormones to grow; about one-third of women with breast cancer show a decrease in breast cancer growth after removal of their ovaries.
A woman has a 1 in 70 chance of developing cancer of the ovary during her lifetime. Some women with a family history of the disease opt to have their ovaries removed to prevent cancer. The mutated genes responsible for most hereditary ovarian cancers have been identified, and women can have a blood test to see if they are a carrier of this gene. Those who are carriers sometimes consider ovarian removal because, due to the lack of symptoms, the presence of ovarian cancer is typically not discovered until a late stage.
Developed at Drexel University College of Medicine in Philadelphia, the SPA procedure has been used for several other types of surgery as well. Stephanie A. King, MD, performed this operation using a set of high dexterity instruments called RealHand, developed by Novare Surgical Systems, Inc. The tools are designed to mirror the surgeon’s hand direction with the added benefit of tactile feedback.
The SPA technique used by Dr. King was developed by Paul G. Curcillo, II, M.D., vice chairman of surgery and director of robotic and minimally invasive surgery at Drexel University College of Medicine. Dr. Curcillo has already completed more than 15 procedures using this technique, including six gallbladder removals and several hernia and stomach surgeries. This is the first time the technique has been used for gynecologic surgery. All of the procedures leave a hidden scar in the patient’s belly button.
Other pioneering surgeons have been working on “natural orifice” procedures, entering through the mouth, rectum or vagina to minimize scarring. The combination of SPA and high dexterity instruments allows for easy application by general laparoscopic surgeons and gynecologists.
