Q&A: Minimally Invasive Women's Surgery

Janis Fee, MD, is physician site director of obstetrics and gynecology for St. Joseph Heritage Medical Group and has been in practice for over 25 years and on the medical staff at Providence St. Joseph Hospital for the past 20. Seven years ago, she began performing even more minimally invasive surgeries for her patients with the addition of robotics. Last fall, Dr. Fee passed a milestone when she performed her 750th robotic surgery.

What makes minimally invasive surgery better than traditional surgery?

The instrument we use, Intuitive’s da Vinci Xi robot, allows for better visualization; we can dissect better, and we have a more natural wrist movement for suturing. With minimally invasive surgery for hysterectomy, for example, we make three small incisions of about 8 millimeters each and sometimes an umbilical incision, so there is a lot less cutting. Patients have quicker recoveries and fewer complications, and they return to their lives and activities sooner.

Do all hospitals offer robotic surgeries?

At Providence St. Joseph, we have one of the most vigorous programs in Orange County. Data from around the country show that centers with high volumes of robotic surgeries have better outcomes. At Providence St. Joseph, we have not only high-volume gynecologic surgeons such
as myself and several of my colleagues, but also a team approach, with mentoring and growth opportunities for the surgeons entering this field.

How difficult is the long-term recovery from this type of surgery?

We practice an enhanced recovery after surgery (ERAS) protocol; we give patients pre-surgical medications and other preop protocols. We have them carb-load the day before and increase hydration. These steps mean less interruption in bodily functioning. Most patients are home the same day of surgery and back to light work the next week.

How common are hysterectomies?

Hysterectomy is one of the most common surgeries in the United States. Some of the reasons for the surgery include fibroids, abnormal bleeding, pain, and organ prolapse. It is gratifying that a simple procedure can alleviate years of suffering.

What can women do to avoid the need for this or other surgeries?

Luckily, there are also many nonsurgical conservative measures that work, if the problem is caught early. Unfortunately, we are seeing a great deal of delayed medical care because of COVID-19. Women have had fewer biopsies for pre-cancer and have avoided evaluation for
painful conditions. We want you to know that it’s safe to get medical care. We follow rules for social distancing, we test and screen, and we stagger patients.

When is it imperative that you get care?

When you have postmenopausal bleeding, you need to see a doctor. That is never normal. If you
have severe pain, requiring medication during your period, you also need to see a medical practitioner. And if you have a family history of uterine, breast or ovarian cancer, you need to see a doctor, who may suggest additional screenings. Women shouldn’t put off mammograms. And Pap smears are still crucial, since cervical cancer is almost completely preventable with screenings.

For more information or to schedule an appointment or health screening, call 844-925-0945.

The da Vinci Xi robot is available thanks to the philanthropic support of generous donors.