Women in the United States commonly undergo obstetric and gynecologic surgical procedures, and, according to one study published by the National Institutes of Health (NIH), obstetric and gynecologic procedures comprised 5 of the top 10 most common surgical procedures in the United States. Indeed, that same study found that between 1979 and 2006, over 137 million obstetric and gynecologic procedures were performed in the United States alone.

Women's Health Center at Door County Medical Center

At the Women's Health Center at Door County Medical Center (DCMC), we are dedicated to providing comprehensive and easily accessible healthcare for women in Door County and Kewaunee County. Situated within the Sturgeon Bay campus of Door County Medical Center, the Women's Health Center offers a wide range of OB-GYN services, diagnostic imaging, birthing facilities, and massage therapy. "At DCMC we do everything related to women's health," says Dr. Elizabeth Gaida, Obstetrician-Gynecologist at DCMC's Women's Health Center. "We treat women of all ages—from children and adolescents all the way through to menopause, through pregnancy, and wellness exams—we do it all."

Setting itself apart from most rural hospitals in the United States, DCMC and the Women's Health Center provide patients with the opportunity to undergo minimally invasive surgical procedures using the da Vinci Xi surgical robot. "It's the latest and greatest technology," says Dr. Gaida. "As a surgeon in the Air Force, I trained in robotic surgery." She continues, "I moved to Door County with my family, not only for the beautiful area, but also so I could maintain that skillset that I had learned in the military."

The da Vinci Xi surgical robot

The da Vinci Surgical System is an advanced surgical robot that employs 3D technologies to aid surgeons during operations. Since 2000, skilled surgeons have safely utilized this cutting-edge technology, although not all hospitals offer it.

The robot's mechanical wrists exceed the capabilities of a human wrist—bending and rotating inside a patient's body in a manner that allows for more effective and less invasive surgeries. The surgeon maintains complete control over the robotic arms, and the da Vinci Xi robot is able to translate the surgeon's hand movements into the smaller and more precise movements of the robot's miniature instruments. With the assistance of the 3D-HD vision system, surgeons are provided with a highly magnified view that virtually extends their eyes and hands into the patient's body.

The benefits of minimally invasive surgery with the da Vinci Xi robot

Minimally invasive surgery generally results in shorter hospital stays and reduced recovery time for the patient. With robotic surgery, both hospital stays and recovery time are reduced even further. "The visualization with the da Vinci cameras is 3D optics," Dr. Gaida notes, adding, "That allows us to be more precise, to do more surgery more quickly, and to be more proficient and more efficient in the operating room. Surgeries tend to be shorter and with less bleeding." "All of that," she adds, "leads to patients going home faster and with less pain. And that in turn," she continues, "results in a faster recovery."

Available gynecological procedures with the da Vinci Xi robot

Ovarian cysts: With this procedure the surgeon removes fluid-filled sacs or pockets called cysts from the ovaries. Most cysts are harmless and disappear naturally, but some—particularly ruptured cysts—can cause serious symptoms like pelvic pain, fullness, and bloating. Using the da Vinci Xi robot, surgeons make small incisions, use robotic arms to locate and remove the cysts from the ovaries. The entire cyst is usually removed, but if not possible, as much as possible is taken out.

Endometriosis resection: Endometriosis occurs when the uterine lining (endometrium) grows outside the uterus, typically affecting the reproductive organs like ovaries and fallopian tubes. Symptoms include chronic pelvic pain, heavy menstrual bleeding, pain during sex, and fertility problems. Robotic-assisted endometriosis surgeries using the da Vinci Xi robot offer a minimally invasive option for removing endometrial tissue, similar to myomectomy, and can help alleviate these symptoms.

Myomectomy: Fibroids are noncancerous growths that are generally found inside the uterus or its walls. Fibroid symptoms can vary widely from non-existent to so significant that they disrupt some women's daily lives. Symptoms can include: heavy menstrual bleeding, pelvic pain, infertility, and miscarriages. While a hysterectomy is occasionally performed in order to remove both the fibroids and the uterus, it is also possible to perform a minimally invasive, robot-assisted myomectomy with the da Vinci Xi robot, thereby removing the fibroids while leaving the uterus intact.

Hysterectomy: There are 3 types of hysterectomy. A supracervical hysterectomy involves the removal of the upper portion of the uterus. A total hysterectomy involves the removal of the entire uterus and cervix. In both supracervical and total hysterectomies, the fallopian tubes are also removed. If the ovaries are removed, either because of patient preference or a medical condition, the procedure is called an oophorectomy. The third type of hysterectomy—a radical hysterectomy—is typically only performed for cancerous conditions by a gynecologic oncologist.

In the past, hysterectomies were conducted as open surgeries, which involved a large incision in the abdominal area, similar to a cesarean section. However, with the da Vinci Xi surgical robot, surgeons can now perform this procedure through a few small incisions that are each approximately 8mm in diameter. Most robotic hysterectomy patients go home on the day of surgery to rest and recover in the comfort of their own home.

About Dr. Elizabeth Gaida

Dr. Gaida is originally from Blaine, Minn. Following her undergraduate education at Marquette University in Milwaukee, WI, she returned to Minnesota for medical school, then joined the US Air Force for OB/GYN residency. Dr. Gaida spent the last 13 years on active duty, achieving the rank of Lieutenant Colonel and serving as Medical Director of Women's Health Services at Keesler Air Force Base in Biloxi, MS.

On her approach to her medical practice, Dr. Gaida remarks, "Each patient is unique. There is no one-size-fits-all that works for everyone. I strive to provide compassionate, evidenced based, patient-centered care that fits the needs and goals of each patient. My goal is to provide the patient with an accurate diagnosis and educate them on all available treatment modalities so they can choose the treatment that is best for them." She adds, "If a surgical option is chosen I'm able to offer a variety of surgical techniques, including da Vinci robotics, to minimize postoperative downtime for the patient while maximizing surgical outcomes."