Robotic Surgery for Treating Ovarian Remnant Syndrome and Other Issues

Dwight D. Im, M.D., F.A.C.O.G.
June 12, 2012
Filed under Health & Wellness

Gynecologic oncologist Dwight D. Im, M.D., is Director for the Gynecologic Oncology Center at Mercy Medical Center

Sometimes a woman has her ovaries removed only to find out the surgery didn’t remove all of the tissue, which can cause some serious complications–including ovarian remnant syndrome.

Small pieces of ovarian tissue are left behind and it grows back, and sometimes, into a big mass the size of an orange or even a grapefruit. Symptoms of ovarian remnant syndrome include chronic pelvic pain, bloating, difficult or painful intercourse, and pain during urination and bowel movements.

Women who have a history of endometriosis and pelvic inflammatory disease are at increased risk for incomplete ovarian removal. Women who have had numerous abdominal or pelvic surgeries are also at risk due to the development of scar tissue or adhesions. Such adhesions can make it more difficult for the surgeon to remove the ovaries in their entirety.

Further surgery is the only way to correct ovarian remnant syndrome. One approach is robotic surgery and an approach I refer to as “Imsway.”

IMSWAY is a robotic surgical alternative to traditional open and laparoscopic surgical approaches for addressing all manner of serious gynecologic conditions, including but not exclusive to, retroperitoneal hysterectomy, the removal of large fibroids, removal of severe endometriosis, surgical treatment of ovarian remnant syndrome, and other maladies involving the uterus.

IMSWAY involves these elements: entering the retroperitoneal space using the infundibulopelvic ligament; the medial leaf of the peritoneum; skeletonization of the ureter, water under the bridge, arriving at the origin of the uterine artery – IMSWAY.

Using the da Vinci robot as a tool to enter the retroperitoneal space, it is possible to identify all the vital organs, big blood vessels and veins, and remove the ovarian remnants without injuring those vital organs.

Women who have ovarian remnant syndrome will not have the usual post-menopausal symptoms associated with having their ovaries removed, like night sweats, hot flashes, insomnia and depression.

Ovarian remnant syndrome is just one example of gynecologic pelvic surgeries that may be performed robotically. Until recently, the only choices women had when it came to hysterectomy was the traditional surgery, which meant a sizeable incision and a longer recovery; or the transvaginal surgery, which makes no incision, but the doctor can’t see the entire abdominal cavity.

Using the da Vinci robot for robot-assisted hysterectomy is now a minimally invasive option for some patients.

Currently, not every doctor does the operation as physicians must go through a long training process in order to be certified on the da Vinci robot. Some call this the future, but the future is here.

Gynecologic oncologists are beginning to recognize that robot-assisted surgery is a viable option for cancer patients and, in fact, are rapidly becoming the gold standard.

Dr. Im Named First Epicenter Gynecologic Surgeon for Robotic Surgery: As a top-rated surgeon and leading-edge specialist in Robotic Surgery, Dr. Dwight Im was the first surgeon to be named a “Gynecologic Oncology Epicenter Surgeon” for the da Vinci robot. Dr. Im trains doctors from around the world in advanced, precision robotic surgery. As important as Robotic Surgery has become, not all patients are candidates for it and the need to perform Laparoscopic and Traditional Invasive Surgery still require superior surgical techniques.


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