For thousands of women, endometriosis, uterine fibroids and pelvic floor prolapse are an unpleasant fact of life. Although benign, these conditions can cause pelvic pain, uncontrollable bleeding, infertility and a fallen uterus.

While these conditions may be treated effectively with open-incision surgery, the resulting pain, scarring and lengthy recovery are difficult. Many gynecologic conditions can be treated with minimally invasive robotic surgery.

Robotic surgery has transformed gynecologic care at South Miami Hospital. Robotic technology allows our surgeons to relieve painful, potentially harmful conditions without a big incision.

“Our internal data relating to outcomes compares favorably with other well-known facilities, such as Mayo Clinic, Cleveland Clinic and the University of Michigan,” says Rafael Perez, M.D., OB/GYN and medical director of South Miami Hospital’s Fibroid Center.  “This tracking of outcomes data will serve to better define best clinical practices as we combine cutting-edge technologies with scientific reporting on what works.”

South Miami Hospital offers robotic procedures for benign gynecologic conditions. The robot-assisted hysterectomy removes noncancerous uterine fibroids and treats endometriosis. Myomectomy, which is a hysterectomy alternative, removes fibroids while preserving the uterus for women who want to become pregnant. Sacrocolpopexy treats pelvic floor prolapse by providing long-term vaginal support.

Gynecologic Oncology

Understanding treatment options for gynecologic cancer is key. Previously, these options were limited to traditional open surgery — a method that requires a large incision, substantial scarring and a long, painful recovery.

Today, most women with uterine, cervical and some ovarian cancers have surgical alternatives. At South Miami Hospital, surgeons perform many lifesaving gynecologic cancer treatments without a large incision.
“Robotics has allowed us to treat gynecologic cancers with minimally invasive techniques that are far superior to laparoscopy alone,” says Ricardo Estape, M.D., medical director of South Miami Hospital’s Center for Robotic Surgery.

“We’ve been able to do a more radical surgery with significantly less blood loss in gynecologic cancer patients,” says Dr. Estape. “We have one of the largest experiences in the U.S. with fertility-sparing surgery for cervical cancer and have had many successful pregnancies.”

With robotic technology, surgeons can operate deep inside the abdomen through tiny incisions. Using specialized instruments and multi-image cameras, our surgeons target the cancerous area with pinpoint accuracy. For patients, this means a faster, less painful recovery and healthier prognosis.

ENT Surgery

Throat cancer covers a broad range of conditions that can involve the voice box, the base of the tongue, tonsils or other areas of the neck. Traditional treatments — chemotherapy and radiation — can limit a patient’s ability to swallow, speak and eat. In addition, removing cancerous tumors with conventional open surgery typically involves long incisions through the throat and the jawbone. That process disrupts the normal functions of speaking, swallowing and eating, and can be disfiguring.
Throat and tongue surgeries have been refined at South Miami Hospital. Ear, nose and throat surgeons also provide effective treatments for benign tongue ailments and throat cancer, using robotic surgery.
“This minimally invasive surgery is less extensive than standard surgery and can reduce recovery time and side effects,” says Rolando Molina, M.D., otolaryngologist.

Robotic surgery uses a camera, small instruments and a laser to remove tumors in the throat. The process enables the surgeon to treat early- and moderate-stage tumors, along with benign problems with the tongue, without disfiguring the patient’s face.

Urology

South Miami Hospital urologic surgeons are successfully using the robot to remove cancerous tumors of the prostate and kidneys, and to treat benign conditions as well. Compared to both traditional open and conventional laparoscopy, robotic urologic surgery provides surgeons with enhanced visualization, improved dexterity and better maneuverability around sensitive anatomy. This translates to fewer post-surgical complications for the patient and a quicker return to normal genitourinary function.

“Outcomes in urologic surgery, both oncologic and functional, are directly related to experience,” says Darren Bruck, M.D., urologist. “Over the past five years, we have performed over 300 procedures and have been leaders in bringing robotic surgery to the Miami community. Our vast experience has led to superior patient outcomes.”

Thoracic Surgery

Robotic surgery has transformed the way patients experience thoracic surgery. Traditional surgery in the chest cavity can be debilitating. Patients endure large and painful incisions, a long recovery and the risk of complications.

The robot makes thoracic surgery easier by allowing access to the chest, without a long incision and spreading the ribs.

“In our experience, the robotic dissection of critical structures is precise, and the three-dimensional, high-definition imaging makes the procedure inherently more accurate than with conventional instruments performed through a utility incision,” says Mark Dylewski, M.D., thoracic surgeon.

South Miami Hospital’s Center for Robotic Surgery pioneered using the robotic system for many thoracic procedures, including cancer surgeries in the lungs, esophagus and thymus, as well as for benign lung and esophageal conditions.

Bariatric/General Surgery

Our surgeons are national leaders in using the robot for weight-loss surgery, including gastric bypass, adjustable band and revisional bariatric procedures.

“We began using the robot to perform bariatric surgery about a year ago,” says Anthony Gonzalez, M.D., general surgeon and medical director of South Miami Hospital’s Weight-loss Surgery Program. “Very few doctors are using the robot to perform bariatric surgery, yet we have been successful for both primary and revisional surgeries. Robotic surgery has demonstrated a decrease in leak rates compared to the similar experience in laparoscopic surgery.”

The robot gives physicians technical advantages — improved ergonomics, better visualization and more precise instrumentation. Our surgeons can perform the delicate and complicated surgeries with agility and accuracy because the robot’s microinstruments allow them to deftly navigate inside the abdomen.

Colorectal Surgery

The colorectal surgeons at South Miami Hospital are using the robot as a tool to treat benign and malignant diseases of the colon and rectum, including cancer, diverticulitis and rectal polyps. It is the latest evolution in colorectal surgery, giving our surgeons unmatched precision and control.

With the robot’s high-tech, 3-D imaging, surgeons see deep into the confined pelvic region, examining delicate nerves and tissues. The picture provides an unparalleled view of the diseased area.

How Does Robot-Assisted Surgery Help?

Surgical “robots” are not technically robots, because they cannot be programmed to move on their own. These robots translate the surgeon’s maneuvers into real time — twisting, turning and rotating the micro-instruments as each operation demands.

With unparalleled accuracy, a surgeon can extend the range of motion and operate deep within the body.
Specially trained and board-certified surgeons at South Miami Hospital use the robot to perform various surgical procedures.

The benefits of robot-assisted surgery include:

• Less pain
• Reduced blood loss and fewer transfusions
• Lower risk of infection
• Shorter hospital stay
• Faster recovery and return to normal activities
• Smaller incisions and minimal scarring

My name is Ricardo Estape and I am a gynecologic oncologist. I started the robotics program at Baptist Health South Florida’s South Miami Hospital in 2006. Since then we have grown to a six-robot program with more than 1,200 cases performed each year in multiple surgical specialties.

Our gynecologic, gynecologic oncology, thoracic and bariatric robotic programs are ranked near the top in the world in volume. We have also recently started an ear, nose and throat (ENT) program that is doing marvels with throat and tongue surgery. Our other programs in urology, colorectal surgery, general surgery and infertility are also very busy and have been leading the community in education and advancements.

We currently have more than 40 surgeons performing robotic surgeries daily and improving the care of our community, which includes not only South Florida, but also the southeastern United States, the Caribbean, and Central and South America. We have a yearly robotic symposium, and we do daily case observations, courses and proctoring at South Miami Hospital’s Center for Robotic Surgery. We are currently building an education center with simulators for an even better educational process.

We hope this website will help you in your practice by showing you our techniques and data, and offering you a place to send your patients for robotic surgery where you know they will be treated by experienced surgeons.

Ricardo Estape, M.D.
Medical Director
South Miami Hospital’s Center for Robotic Surgery