Minimally Invasive and Robotic Assisted Surgery

Both Dr. Mudge and Dr. Hogenson have experience as robotic surgeons, using the da Vinci surgery system. Dr. Mudge has been certified as a da Vinci robotic surgeon since 2009. Common indications for robotic assisted surgery include: hysterectomy, myomectomy (removal of fibroids), surgery for endometriosis, tubal reversal surgery to restore fertility, and pelvic organ prolapse surgery. Dr. Mudge is the only surgeon performing robotic tubal reversal surgery in Alaska. Our surgeons will discuss with you the optimal approach to minimize surgical risks and enhance your recovery.

The System

With the da Vinci surgical system, small incisions are used to insert miniaturized wristed instruments and a high-definition 3D camera. Seated at the da Vinci console, your surgeon views a magnified, high-resolution 3D image of the surgical site inside your body. At the same time, the latest robotic and computer technologies scale, filter and translate the surgeon's hand movements into precise micro-movements of the instruments.

Although it is often called a “robot”, the da Vinci System cannot move or operate on its own; your surgeon is 100% in control.

Surgical Approaches

Open Surgery

For generations, open surgery has been the standard approach to many gynecologic procedures and is still used today. With open surgery, a large incision is made in your abdomen - large enough for your surgeon to fit his/her hands and instruments inside your body. However, with open surgery there are certain drawbacks and trauma to the body due to the large incision. There are now less invasive surgical options for many women facing gynecologic surgery, although open surgery is still indicated at times.

Laparoscopic Surgery

One way of minimizing the recovery faced by women undergoing surgery is the minimally invasive surgical technique of laparoscopy. Instead of a large open incision, surgery is done through a few small incisions using a tiny camera and long, thin surgical instruments. The camera takes images inside your body and those images are sent to a video monitor in the operating room which guides surgeons as they operate.

Robotic Assisted Laparoscopic Surgery

Robotic assisted Surgery is the newest minimally invasive option for women facing gynecologic surgery. Fairbanks Memorial Hospital now owns a da Vinci robot (the most popular brand of surgical assist robot) and cases are performed on a daily basis. With the da Vinci robotic system, surgeons make just a few small incisions - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. The system translates the surgeon's hand movements into smaller, more precise movements of tiny instruments inside your body allowing for more control during surgery, and better visualization.

Robotic surgery is beneficial for performing complex surgery that might be too challenging to perform with conventional laparoscopy.

Using FireFly for Endometriosis

The da Vinci robotic system offers some potential advantages to women having surgery for endometriosis. Using Firefly imaging, which is only available for the robotic system because of the specialized camera, blood flow to anatomic structures is illuminated. This allows even very small or atypical appearing lesions of endometriosis can be seen in real time, allowing for more complete removal or cauterization of the endometriosis. The endometriosis will appear indigo or bright green under the integrated fluorescence imaging.