Washington: A surgeon at the University of Texas Medical Branch at Galveston has performed a groundbreaking robotic laparoscopic procedure on a 35-year-old pregnant patient of Galveston, whose cervix was too short to sustain a pregnancy.

Dr. Sami Kilic, chief of minimally invasive gynecology and research at UTMB, is the first surgeon in the world reported to have used robotically assisted, ultrasound-guided laparoscopic surgery to successfully tighten a pregnant patient's incompetent cervix.

Kilic performed the surgery in December 2011 at UTMB's John Sealy Hospital. When performed traditionally, abdominal cerclage surgery requires a large incision and a long period of recovery. Kilic's new procedure left the patient with only three tiny abdominal scars.

"The recovery was amazing. Two days later I was able to sit on the floor at home and play with my toddler," new mum Leonora Orejuela said. Stitches to the cervix during surgery must be precise; a suture placed a hair's breadth the wrong way can puncture either the amniotic sac or a major blood vessel in the mother.

With the dual visualization screen of the da Vinci Si robotic surgical system, Kilic was able to view a real-time ultrasound image on one screen and the operative field via scope camera on another screen, side by side, at the same time he performed the surgery. This two-screen system offers unsurpassed visualization in a laparoscopic surgical situation.

Kilic is an international pioneer in gynecologic robotic surgical techniques and training protocols who was hired by UTMB five years ago to spearhead a state-of-the-art robotic surgery training program. Orejuela, the patient, was discharged home the next day after a one-night stay in the hospital. Orejuela proceeded to have an otherwise uncomplicated pregnancy, going into labor at 36 weeks.

She delivered a healthy baby girl, Lucia Munoz, 6 pounds, 11.5 ounces, by Caesarean section. The procedure is published online in the Journal of Minimally Invasive Gynecology.


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