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Ann Lutich, M.D. Answers Questions On Minimally Invasive Gynecologic Surgery

Ann Lutich, M.D. Answers Questions On: Minimally Invasive Gynecologic Surgery

Why use a robot in laparoscopic gynecologic surgery?

The optics are so much better. You can see the tissue planes in three dimensions instead of two – that’s what’s helpful. When you have endometriosis involving the ovary, you’re really able to dissect cysts out of the ovaries so much better and more completely, and then are able to reconstruct the ovary afterward. So you're saving the good ovarian tissue.

In general, laparoscopic surgery can be extremely advantageous. Especially in patients who are overweight, if you can avoid a large abdominal incision, then the chances of wound separation, infection, and all other complications are so much lower.

Do you offer alternatives to surgery?

We have a whole armamentarium full of nonsurgical and sometimes conservative surgical therapies – for example, endometrial ablation for heavy periods as opposed to hysterectomy. We try to give patients the option for those types of therapies as a first line prior to doing more definitive surgery, such as a hysterectomy.

What do you think of hormone therapy?

Probably the biggest misconception is that most problems in women are a result of hormonal imbalances. While hormonal imbalances can cause disease, there are a lot of symptoms that are not related to hormones. Yet patients come in all the time on hormone regimens that I think are not doing good things for them. If I were to take any woman and load her up with estrogen and testosterone, she might feel good, but what are the side effects of that? You've got to understand what's going on with her own ovarian hormonal production and then be able to diagnose where the deficiencies are and what’s going to be in her best interest.

I try to educate patients about what actually is going on with their hormones throughout the various life stages. It’s complex, and it can be confusing. It’s incumbent upon us as gynecologists to talk to patients about these things, to educate them and help them to understand what’s going on with their bodies and make the appropriate decisions.