Brinkmann Gynaecology

Surgery choices

When surgery has been recommended there are essentially three options available to you:

  • Open surgery
  • Laparoscopy 
  • Robotic surgery 

Open surgery

The majority of gynaecological operations on women in the UK are still performed using “open” surgery, where access is gained through a large open incision. Because of trauma to surrounding tissues, open surgery inherently has increased wound complications and a significantly longer recovery time.

Minimal access surgery

The use of minimal access surgery (also called laparoscopic or keyhole surgery) means that large open incisions can be avoided minimising trauma and the impact on your body and the time it takes to recover. Depending on your situation you may be a candidate for minimal access surgery.

Mr Brinkmann can recommend minimal access surgery wherever possible to reduce patient discomfort, promote more rapid healing and minimise the effect of surgery on patients.

Laparoscopic surgery

Laparoscopy can be used to help diagnose a wide range of conditions that develop inside the abdomen or pelvis. It can also be used to carry out surgical procedures, such as removing a damaged or diseased organ, or removing a tissue sample for further testing (biopsy).

During laparoscopy, the surgeon makes one or more small incisions in the abdomen. These allow the surgeon to insert the laparoscope and small surgical tools to perform the operation with less trauma to the surrounding tissues.

You usually go home on the same day or day after you have laparoscopy and recovery times are faster than traditional open surgery.

The biggest surgical challenges of laparoscopy include working in a three-dimensional field while having only a two-dimensional view (the TV monitor) and the lack of dexterity associated with typical straight laparoscopic instruments.

Robotic surgery

For some conditions, Mr Brinkmann may recommend robotic surgery. Robotic technology addresses both the constraints of traditional laparoscopic surgery by providing a 3-D view and instruments with dexterity.

Robotic surgery uses a sophisticated robotic system to perform laparoscopic surgery. It allows surgeons to perform many complex procedures with more precision, flexibility, control and manoeuvrability than in traditional minimally invasive surgery. Some people who aren't candidates for open or minimally invasive surgery may be candidates for robotic surgery. This is particularly true of larger patients who may not be considered suitable for laparoscopic surgery due to their size.

Surgeons using the robotic system can perform delicate and complex procedures that may have been difficult or impossible with other techniques. It has the enhanced benefit of offering fertility preserving surgery for certain patients who still want to have a family after treatment. This was often not possible before.

In robotic surgery, or robot-assisted surgery, surgeons make a few small incisions to insert the robotic system (rather than the laparoscope in laparoscopy). This includes a camera arm and several interactive mechanical arms, with joints that work like a human's wrist.
Your surgeon guides the procedure from a remote console close to the surgical table and views the surgical area in a 3-D magnified view on a monitor. This offers greater depth perception and detailed views than does open surgery. Your surgeon leads a trained surgical team during the surgery.

Compared with a previous two to three month recovery with open surgery, you usually go home on the same day or day after robotic surgery and recovery times are dramatically quicker.

Benefits of minimal access surgery

When you have minimal access surgery, you're likely to lose less blood and have less postoperative pain, fewer and smaller scars, and a faster recovery than you would after open surgery. It has the added benefit of reduced pain medication requirements all due to less trauma during surgery. Depending on your condition, you may need only a short hospital stay. You are likely to return to normal activities more quickly than after open surgery.

Mr Brinkmann is a highly experienced laparoscopic surgeon with extensive experience of complex major surgery for benign and cancer gynaecology. He is the clinical lead for gynaecology cancer in Portsmouth and led the implementation of robotic surgery for gynaecology at Queen Alexandra Hospital. Private patients can benefit from robotic surgery at the Private Patient Unit there.

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