By Brenda Bouser
Once used exclusively for
prostate surgeries at FirstHealth Moore Regional
Hospital, robot technology is now being used for certain
The da Vinci Robotic Surgical System allows
gynecologists to perform some complex hysterectomies,
as well as uterine fibroid removal and pelvic support
reconstruction, as minimally invasive procedures. Because
the operations are done through a few tiny incisions
instead of one large one, patients typically have less pain,
shorter hospital stays and much faster recovery.
With robot-assisted procedures, the surgeon sits at
a console a few feet from the patient and guides the
movement of surgical instruments at the end of the
robot’s arms. Two cameras mounted on a scope, which
is inserted through a small incision, transmit threedimensional
video images of the surgical field to a
monitor in front of the console, giving the surgeon a
remarkably clear view.
“The visualization is unprecedented,” says Walter
Fasolak, D.O., an obstetrician and gynecologist with
Southern Pines Women’s Health Center. “The two
cameras at the tip of the scope are within an inch or two
of what you’re operating on, so you’ve got a beautiful view that fills the screen.”
Stephen Szabo, M.D., an OB/GYN specialist with Pinehurst Surgical’s Women’s Care
Center, says the robotic system allows him to maneuver surgical instruments more
precisely than is possible with conventional laparoscopic surgery.
“When you are sitting at the console and controlling the instrument, it’s almost like
the instrument is in the palm of your hand,” he says. “It’s much like the feeling of openincision
surgery. Suturing is more precise, and dissecting tissue to identify veins and
arteries is easier and more controlled. The system is designed to be like an extension of
your body, so you think it and it happens.”
Because of the availability of robot technology, surgeons can now offer more patients
the benefits of minimally invasive surgery. “I can do more difficult, complex cases on
patients who otherwise wouldn’t be able to have laparoscopic surgery,” Dr. Szabo says.
“The robot allows me to take a big, conventional open surgery and turn it into a surgery
where the patient is going to go home the same day or the next day and will be pretty
much back to normal in a week rather than a month.”
Dr. Fasolak describes the robotic system as a major advance in gynecologic surgery.
“There is tremendous satisfaction in being able to offer it to patients, because they are
certainly going to benefit from it,” he says.
Two patients, two surgeries, one robot
Kathy has vivid memories of the traditional
hysterectomy she had back in the early
1990s—especially the large incision, the
pain and the wrenching nausea caused by her pain
Because those memories stayed with her, she had
an unusual question for her gynecologist when it
became apparent that she would need extensive
pelvic reconstruction surgery. “Will you be using the
robot?” she asked.
As she recalls, the rest of the conversation went
something like this: “He said, ‘Yes,’ and I said,
Walter Fasolak, D.O.
Stephen Szabo, M.D.
Kathy, who did not want her last name used for
this story, had her surgery on Jan. 9, 2009, joining
an increasing number of women in the mid-
Carolinas who have chosen robotic surgery for their
gynecologic procedures. Both Walter Fasolak, D.O.,
of Southern Pines Women’s Health Center, (who
was Kathy’s surgeon), and Stephen Szabo, M.D.,
of Pinehurst Surgical’s Women’s Care Center, are
certified to use the da Vinci Robotic Surgery System
at FirstHealth Moore Regional Hospital.
Shelley Burge also had a good experience
with her da Vinci surgery, a total laparoscopic
hysterectomy to deal with heavy bleeding caused by
tissue build-up on the wall of her uterus. Although
not previously familiar with robot-assisted surgery,
she was comfortable about having the procedure
after Dr. Szabo explained it and its advantages to
“My doctor was still in control of the robot,”
Burge says. “He was at the helm. I had that trust
and relationship with Dr. Szabo. I absolutely trusted
The prospect of a speedier recovery and earlier
hospital discharge was especially important to the
34-year-old Burge, a military wife about to move
with her husband and two young children from
Fort Bragg to Fort Gordon, Ga. She had her surgery
on Dec. 30, 2008, and the family left for Georgia on
Jan. 23, 2009. She says she did a lot of the packing,
and even some lifting, without any problems at all.
“I’m fine,” says Burge. “I didn’t have any trouble
at all, just a little bleeding that was just the sutures
healing, but nothing to worry about. I’ve really
According to both surgeons, some women have
doubts about entrusting their surgery to robot
technology, but Kathy, like Shelley Burge, had
absolutely no reservations.
“Some people are hesitant to do it,” she says.
“They think it’s too far out, but I’m very openminded
about that kind of thing, and I trusted Dr.
For more information on robot-assisted surgery
at FirstHealth Moore Regional Hospital, call (800) 213-3284.