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Dr. Shaw is proud to offer the latest technology for management of urologic disorders with robotics. Dr. Shaw was amongst the first surgeons in the area to offer da Vinci Robotic Laparoscopic Sacrocolpopexy to patients, and began his training in robotics in 2000 while in residency at Tulane, the first robotics program in the Gulf Coast region.
Dr. Shaw has been chosen since 2004 to be one of a select group of surgeons from Intuitive Surgical, to be a nationwide proctor of da Vinci Robotic Surgery. Dr. Shaw routinely participates in national and international events for robotic surgery, keeping up with the latest technology in this rapidly expanding area of Urology.
The classic treatment of cystocele or rectocele required large abdominal or vaginal incisions.
Newer treatment of cystocele and rectocele involves minimally invasive surgery. Dr. Shaw is able to replicate the same procedure that is done with a large (open) incision with the latest technology. Dr. Shaw is proud to offer da Vinci laparoscopic, robotic and vaginal repair of pelvic prolapse issues.
What is da Vinci Robotic Surgery? Simply put, the reason why we used to make large incisions for major surgeries was so we could put our hands inside the body. With the advent of robotics, we perform the same surgery, arguably better, with smaller incisions, because instead of the surgeon’s hands, we only need to make a few small 1/2 inch incisions to insert the robotic hands. From there, we use 3-D vision, High Definition (HD) Cameras and the latest technology to translate the surgeon’s hand movements to the robotics. Think Wii for robotic surgeons!
All this technology translates to more precise movements, vision that is magnified in 3-D and other benefits. Results? Our patients rarely require blood transfusions, have less pain and smaller incisions than open surgery, and return home in 24-48 hours.
It is critical that you stop any Aspirin, Coumadin, Plavix, or other blood thinners one week before your procedure. Please call our office should you have any questions about this.
The day before your procedure, we ask that you take only a clear liquid diet (soups, broths, etc). However, no eating or drinking after midnight the night before surgery. Wear comfortable, loose-fitting clothing like a jogging suit on the day of your procedure. Bring a list of all the prescription and nonprescription medications that you take regularly with you on the day of the procedure.
You may also be requested to use a Fleet enema the day before your procedure.
Please plan to arrive two hours prior to your treatment.
The procedure usually takes three hours, and Dr. Shaw will come and speak to your family afterward.
Upon waking from the procedure, you will have a catheter draining your bladder. I have yet to meet a person who likes having a catheter, but relax, the catheter typically will remain for just 1-2 days and then be removed.
It is not unusual to have a sensation of wanting to urinate or to have bladder spasms after surgery. This usually goes away within 1-2 days. If symptoms last longer, a temporary anti bladder spasm medication may be required.
Minimal Incisions! That’s the good part. da Vinci Robotic Cystocele/Rectocele repair is performed with 4 tiny incisions, no wider than your thumb. Using the robot, Dr. Shaw is able to repair and restore many of the sagging support structures of the pelvic organs. Mesh, similar to that used to fix hernias, has been shown to markedly improve the repair, and reduce the chance of recurrent bladder or rectal prolapse.
For some women with more complex reconstructive issues, a combined robotic/vaginal approach may be required to achieve optimal results.
After the procedure, although many patients may do fine with no problems, some patients may experience minor, temporary issues such as noticing burning with urination, or frequent urination.
A foley catheter draining the bladder is usually removed 24-48 hours after the procedure.
Definitely rest up for a week after the procedure. Drink at least 6-8 glasses of water, and stay well hydrated.
For pain, Advil®, Motrin®, or prescription Toradol® work great – dependent upon your doctor’s advice. Never take a medication without clearing it with your doctor first. These are non-narcotic, so you don’t get sleepy, constipated or have other issues; however they are great anti-inflammatories. Take them on a regular basis the first 2-3 days after the procedure. For pain not relieved by these medications, use the prescription Tylenol with Codeine or Vicodin that was prescribed for you.
Vaginal spotting may be common, and should gradually decrease after surgery.
No intercourse for six weeks after the procedure.
Do not strain when having a bowel movement. Expect irregular bowel habits until fully recovered. Increase fiber in your diet with fruits, salads, etc. You may need a stool softener or laxative such as Metamucil.
Do not take blood thinners or aspirin products for one week or as directed by your physician.
Take it easy for the first week after the procedure. Do not drive or operate dangerous equipment for one week. You may be able to resume non-strenuous activities after one week unless otherwise directed by your physician. Avoid strenuous exercise, heavy lifting greater than 20 pounds, bike riding, and yard work for two weeks. Try to minimize excessive bending and squatting type maneuvers.
After two weeks, you can gradually increase your work load until 4-6 weeks, at which you can usually resume most activity. The main issue is to reduce chance of a hernia at your incision site, or a recurrence of your prolapse, so please use your common sense! If doing some activity is uncomfortable or hurts, don’t do it!
Stay well hydrated, drinking 6-8 glasses of fluid a day. Eat healthy with lots of fruit, vegetables, and salads.
You may experience bruising or swelling around the incision sites, especially around the navel area. This is normal and should subside in one to two to four weeks. After a few months all the inflammation and swelling will go away, and the incisions will slowly resemble a thin line and barely be visible.
Usually, Dr. Shaw or his staff will communicate to you a desired follow-up time frame. Please call us the day after the procedure to verify a time to see us in the office.
A majority of people will notice a substantial decrease or absence of pelvic pain with standing, urinating, or having bowel movements. Overactive bladder and incontinence are also improved, or are resolved completely.