Robotic-Assisted Surgery


Enhanced Precision and Control

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Using the da Vinci Xi Surgical System, doctors operate through a few small incisions in your abdomen or through the belly button instead of a large open incision. It is similar to traditional laparoscopy except the da Vinci system gives doctors a three-dimensional, high-definition view inside your body.  It also features surgical instruments that bend and rotate far greater than the human wrist. The doctor is always in control of the da Vinci system, which translates his or her hand movements into smaller, more precise movement of tiny instruments inside your body.

There are certain procedures where enhanced visualization, a high-definition, 3-dimensional view of pelvic anatomy, and better precision and control is beneficial. Sometimes certain patient characteristics or details of their medical and surgical history make this option more desirable.

Expertise and skill are two of the most fundamental criteria a patient should desire when choosing a gynecologic surgeon. The da Vinci robot is a surgical instrument that cannot compensate for, or improve, surgical training. Dr. Rebeles is extensively trained in both traditional laparoscopic surgery and robotic-assisted surgery.  She will thoroughly evaluate each patient’s medical history to decide if robotic-assisted da Vinci surgery is the best route for surgery.

Using the da Vinci Robotic System, all or part of the uterus is removed in a minimally invasive fashion. This may or may not include removal of the ovaries.  Patients with complicated medical histories, prior surgeries, or where surgery is anticipated to be challenging may benefit from this technology. Proper recognition and understanding of surgical anatomy are paramount to successful and safe completion of any surgery.

Minimally invasive management of fibroids is one of the more challenging procedures in gynecology because of the difficulties encountered when removing fibroids. Because the uterus is being preserved, blood loss can be substantial. Also, it is important for your doctor to perform a multi-layered closure of the uterus where the fibroids are removed. In certain cases, these challenges may be overcome with the assistance of the da Vinci Robotic System.

Robotic-assisted technology may aid the management of endometriosis by allowing the operator to see more endometriosis. The assistance of the robot is being used by an increasing number of surgeons worldwide to treat endometriosis. This minimally invasive approach, utilizing the latest in surgical and robotics technologies, is ideal for delicate gynecological surgeries. Additionally, Firefly Flourescence Imaging, which utilizes Indocyanine Green (ICG) dye, enhances visual assessment of vessels, blood flow and related tissue perfusion. Firefly can potentially provide more accurate visual diagnosis of endometriosis during a da Vinci robotic-assisted endometriosis resection procedure.

When scarring from previous surgery (such as a previous hysterectomy), or other complicating factors are anticipated, the da Vinci robotic system is often employed. Also, in cases where the cyst is very large or careful dissection is needed to avoid spillage of contents within the cyst, the robotic approach can help accomplish ovarian cystectomy with better precision. Most patients can go home the same day as the surgery.

The robotic-assisted approach can be used for a vaginal suspension procedure such as a Uterosacral Ligament Suspension or Sacrocolpopexy. Both procedures are recognized as an excellent repair for advanced prolapse of the top part (apex) of the vagina, with demonstrated long-term success. Each procedure requires careful attention to anatomy.  The minimally invasive approach is preferred for prolapse repair. The use of the da Vinci Robotic System is employed for better surgical precision, and ease of suturing graft material or suspension sutures to the vagina, which provides for excellent long-term results.

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*Please Note: Dr. Rebeles does not offer prenatal care.
Additionally, Dr. Rebeles is no longer accepting new patients, effective May 1, 2024.