Da Vinci Robotic Hysterectomy

Aaradhya Sharma

https://www.laparoscopyhospital.com/SERV01.HTM  This video demonstrates Da Vinci Robotic Hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Vaginal hysterectomy removes the uterus through an incision in your vagina. Doctors perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision near the belly button. Recovery after a robotic hysterectomy is shorter and less painful than after an abdominal hysterectomy. Full recovery might take three to four weeks. During robotic surgery, your doctor performs the hysterectomy with instruments that are passed through small abdominal cuts (incisions). The magnified, 3D view makes possible great precision, flexibility, and control.  For more information please contact:  World Laparoscopy Hospital  Cyber City, Gurugram, NCR DELHI  INDIA 122002  Phone & WhatsApp: +919811416838, + 91 9999677788

Transcript

00:00hello friends this is a case of da vinci robotic hystectomy this patient is suffering from dub and

00:08we will perform robotic hystectomy she is a 45 year old ladies with a severe dub and several

00:16treatment of the medical treatment is failed so we will perform the robotic hystectomy and here

00:23we will use forearm da vinci hd robot and first i will demonstrate you a little bit about the

00:30surgeon's console of the robot and then we will demonstrate you the entire surgery from the

00:35beginning to the end here we are using this forearm da vinci surgical robot and this is called surgical

00:42console this is the surgical console where the surgeon will sit and surgeon console has the

00:49this is the viewport that you will use to see inside and inside you will see completely

00:55three-dimensional so this is called as viewport now this is left side port this is right side

01:01port and this is master controller master controller when you will move it seeing inside the viewport

01:07you will just move the master controller and your movement of the hand will be translated inside the

01:13abdomen of the patient and this way da vinci robotic surgery can be performed so let us start the

01:20procedure and before that we have to introduce the uterine manipulator here we are using the full circle

01:28colpotomizer uterine manipulator and this will be the you can see tenaculum of the uterine manipulator is

01:35catching the cervix

01:39and then you will hold the anterior and posterior leaf of the uterus

01:44and then you will start operating the instrument so you have the energy sources the foot is controlling

01:52the foot switch is controlling the monopolar and bipolar and this is left side is bipolar maryland

01:59and right side you have the monopolar seizures so you can attach monopolar and bipolar together also

02:07here we are using force fx covedian generator electro surgical generator

02:13and this is anterior leaf of the broad ligament is opened and slowly you can go up to the uv fold on

02:21the right side now this is the fallopian tube and major salpings the bipolar is coagulating fallopian

02:29tube and major salpings and scissors is cutting it this is how your controller has to be controlled by

02:35your right and left hand and master controller is very delicate and when you control it you should be

02:41careful that level of this controller should be at the level of your elbow and the wrist should be at the

02:47level of the elbow and your elbow should rest over the the da vinci viewport pad and this way you can

02:55usually sitting in the chair perform the surgery now this is the ovarian ligament and here it is

03:02now opening the uv fold the colpartumizer as you can see is pushing the uterus and this is uv fold is

03:09open and now bladder will be separated and slowly you can separate the bladder here you can see the

03:15crisscross pattern and now this is uterine artery of the right side right side of uterine artery is

03:21coagulated couple of time two three time and then you can cut it with the seizures during that the left

03:27hand will hold the bipolar and it is coagulating and right hand will support it and we can keep the

03:35seizures also together to control the bleeding and to just dissect the tissue so this is the master

03:43controller again we can see how it moves and this is now left side this is left side round ligament which

03:50is getting coagulated and together cutting with the seizures anterior and posterior leaf of the

03:56left side is open this is fallopian tube of the left side with the major salpings and this is ovarian

04:02ligament of the left side with the major ovarian and just like laparoscopic histectomy here also

04:09anterior and posterior leaf of the broad ligament is open and this is left side posterior dissection is done

04:15now this is left side uterine artery and this is the bipolar is coagulating the uterine artery and it

04:21is cut by the seizures so now this is almost over now assistant will push the corporatomizer this is the

04:29viewport you can you can see this is completely three-dimensional high definition and this viewport

04:35always your head should be inside the viewport if you remove the head out of the viewport your instrument

04:41will become freezed and then you cannot move your instrument so now this is colpotomy and this is

04:48anterior colpotomy here the seizures is cutting and colpotomizer is pushing hard and this is now

04:54right-sided colpotomy and this is now left-sided colpotomy and this is now posterior colpotomy and you can

05:03see utero-cycle ligament is intact and again remaining part of the anterior colpotomy is done and uterus is

05:10pushed out through the vaginal root itself now this is closure of the vault closure of the vault is

05:16very interesting step in the robotic hysterectomy because suturing is very easy by robot and this is the

05:23vault closure is going on we are using bob suture v-lock suture and the vault is closed so this is over

05:31thank you very much for watching this video have a nice day god bless you

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