Division of Gynecologic Oncology

GMBC is the only hospital in Mid-Atlantic region to offer the full array of minimally invasive options for women with benign or cancerous gynecologic conditions including advanced conventional laparoscopy, single incision laparoscopic surgery, robotic surgery and sentinel lymph node technology.

The first single incision laparoscopic endometrial cancer staging case on the East Coast done at GBMC by Dr. Amanda Nickles Fader.

First robotic radical hysterectomy in Maryland performed at GBMC by Dr. Francis Grumbine.

GBMC offers single incision surgery, also known as laparoendoscopic single-site surgery ("LESS"), for select women with: fibroids, endometriosis, ovarian cysts, tubal ligation, hysterectomies, pelvic masses, removal of ovaries, and early-stage endometrial and ovarian cancers.

Mininimally Invasive Surgery:

Using state-of-the-art surgical technology, gynecologic surgeons at GBMC are offering more women the opportunity to undergo major abdominal surgery through tiny or even "scarless" incisions that are associated with dramatically speed up recovery and are associated with fewer complications when compared to surgery through larger incisions. There are many new surgical innovations recently available to women with benign or cancerous gynecologic problems that allow women to undergo major abdominal surgery through tiny incisions. These innovations include robotic surgery, cutting edge technology that allows a surgeon to operate robotic instruments and surgical arms from a remote console, and single port laparoscopic surgery, otherwise known as laparoendoscopic single-site surgery or "LESS".

Robotic surgery:

GBMC was one of the first hospitals in Maryland to perform robotic surgery and have offered it for gynecologic surgery since 2007. The da Vinci system allows the physician to operate through small, dime-sized abdominal incisions and direct robotic "arms" to perform the surgery with a variety of tiny surgical instruments. Seated at a console, the physician views the surgical area through a tiny, endoscopic camera that reveals three-dimensional images magnified 14 times greater than what the human eye can see. The controls at the console allow the physician to move the robotic "hands" with precision, eliminating the natural tremor of even the steadiest of human hands. This allows surgeons to offer more women a minimally invasive approach to performing a complex operation-even in the overweight or obese patient. Surgeries include cancer staging procedures for cervical, endometrial or ovarian cancer, hysterectomy for large or fibroid uteri, treatment of endometriosis and removal of pelvic masses.

LESS Procedures:

LESS is an advanced minimally invasive approach in which the surgeon operates almost exclusively through a single entry point, typically, the patient's navel. Potential advantages of LESS include better cosmetic results from a hidden scar at the base of the belly button (this surgical approach is called "scarless surgery" because patients can't see the incision at the base of the belly button once it has healed), less pain after surgery resulting in the need to use less pain medication, and quicker recovery from fewer incisions.

Dr. Amanda Nickles Fader, M.D. a gynecologic oncologist and minimally invasive surgeon at GBMC, is one of only a handful of gynecologic surgeons in the country trained in LESS procedures. This minimally invasive innovation has recently garnered significant interest across many medical fields, including urology, general surgery, colorectal surgery and gynecology. It remains one of the hottest topics in contemporary minimally invasive surgical research.

Over the last year, Dr. Fader and her colleagues at the Cleveland Clinic have published some of the first studies on the use of single port surgery for gynecologic procedures and have demonstrated that this surgical approach is safe and effective when used to treat a variety of gynecologic conditions including fibroids, endometriosis, pelvic pain, ovarian cysts and pelvic masses. As a gynecologic oncologist, a surgeon who specializes in treatment of precancerous and cancerous female diseases, Dr. Fader has focused her studies on utilizing LESS for women with precancerous conditions like cervical dysplasia, those with pelvic masses or large ovarian cysts, those women at high risk for ovarian cancer who may want their ovaries removed prophylactically to prevent cancer, and for surgeries to treat some early-stage endometrial and ovarian cancers.

Dr. Fader said, "In our first group of published studies, our preliminary data demonstrates that women who undergo single incision laparoscopies use little to no pain medicine after surgery, recover very quickly and are quite satisfied with the cosmetic outcomes because most women can't see their hidden surgical at the base of the belly button."

j vimeo.com/12397392

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