Minimally Invasive Robotic Laser Surgery for
Marja Sprock, M.D.
The medical technology
advances rapidly. Great strides have been made in
changing big abdominal surgeries to laparoscopic or
robotic surgeries. The advantage is smaller scars,
quicker recovery time.
Natural orifice surgery is
another minimally invasive route. What it tries to
accomplish is using natural openings like a mouth or
vagina to perform surgery.
As a doctor in female
pelvic medicine and reconstructive surgery, I will leave
the access through the mouth to the real adventurers and
will use the vagina as an access route, to perform
surgery where scars can be nicely hidden. Recovery is
also usually very fast.
Robotic surgery leaves bigger scars
than surgery by the laparoscope
Robotic scars are around the navel
and difficult to hide when trying to
wear a two piece
Most women who have undergone
successful prolapse surgery wished
they had done it a lot sooner
Botox can be used in the bladder to
help against bladder spasms and is
covered by a lot of insurances
Urinary and fecal incontinence can
often be helped or cured by training
the muscles of the pelvis
Pelvic muscle training can be
achieved by everybody, biofeedback
hysterectomy is usually not
needed/recommended to achieve repair
of a prolapse if done vaginally
Prolapse repair with the robot or
laparoscope can usually leave the
Excessive water drinking is not
healthier and can lead to urinary
retention and incontinence
Retention is only good in a pond
Using the vagina to
perform surgery will not need the robot and for
incontinence surgery the laser is not helpful either.
Neither of the two will make the vaginal access,
minimally invasive surgery any better or faster.
If you are bothered by
incontinence with coughing, sneezing, laughing, working
out, walking around, lifting up the (grand) kids, you
may have what is called stress incontinence. The first
line of treatment should focus on your pelvic floor
muscles. These muscles are often referred to as your
One of the most often heard comments are:” I tried the
Kegels and they do not work”. This may be true and it
may not be enough to cure your stress urinary
incontinence, but other women have practiced by
contracting every muscle in their body except the pelvic
floor muscles. Biofeedback, where the contraction
strength can be seen on a monitor, can be taught quickly
to most women with excellent result.
As with any muscle you
train hard to make strong you have to keep on exercising
the muscle. For your pelvic floor muscles you do not
have to go to the health club though and can train them
If your pelvic floor muscles are up to par and you still
have bothersome stress leakage and need to wear a panty
liner or pad, you may want to consider a minimally
invasive surgery that uses the natural orifice of your
vagina as access. It leaves no visible scars. It is
mostly performed as a quick outpatient surgery, but can
even be done in the office. Obviously some anesthesia
will be provided.
Success rates are between
85-90% and you may want to recuperate the day after to
get the entire anesthesia out of your body, but then you
are back to activity. I would not start with lifting
heavy weights and give the sling some time to heal.
Since the surgery is performed through the natural
orifice called a vagina and has about two stitches,
intercourse will have to wait for about six weeks.
sling (pictured at the left) is made of open weave
polypropylene, a naturally quite inert material and your
own tissue will mostly incorporate it.
The surgery will take
about 5 to 10 minutes, and the result may be life
altering. Maybe the natural orifice surgery is too easy
and we should convert the surgery to a minimally
invasive robotic laser surgery.
Thinking about it ...
guess not really an improvement over what we already
like more information about biofeedback or the minisling
for stress urinary incontinence, please call for an
appointment at 321-806-3929,
send us a
note or visit us online at
Dr. Sprock is affiliated with Central Florida
UroGynecology in Rockledge.