Robotic surgery has been successfully used worldwide for more than 20 years in various fields – mainly in urology, gynecology and general surgery and has shown excellent outcomes for rare and severe diseases. Surgical robots enable surgeons to perform procedures with greater safety, precision and accuracy, with minimal damage to surrounding tissues, the best conditions for suturing and bleeding control, especially when operating in hard-to-reach areas.
Almazov Centre began to use the Da Vinci Si robotic system in 2011. In 2020, the Robotic Surgery Centre was established with a training center headed by Prof. Mikhail Mosoyan. In 2022, the latest generation Da Vinci Xi robotic system was delivered to the Robotic Surgery Centre. It provides the best options for performing procedures on the genitourinary system.
Director of the Institute of Pediatrics and Perinatology Tatyana Pervunina has done significant organizational and methodological work to make robotic surgery a part of the system of specialized medical care for girls with gynecological conditions.
An example of the team approach used by the robotic centre specialists, urologists and gynecologists is the case of successful surgical treatment of a 14-year-old girl with a combined genitourinary anomaly. The patient had no right kidney, which was combined with a doubling of the uterus, the functional right uterus had a cervix, and the left one was in the form of a muscular embankment with no signs of functioning, the vagina was absent (vaginal agenesis). As a result, blood accumulated in the cavity of a functioning uterus and in its cervix. Menstrual blood was thrown through the fallopian tube into the abdominal cavity, and the girl suffered from unbearable recurring abdominal pain. Definitive diagnosis was established by pelvic MRI. It became clear that surgery was the only treatment option for the patient. The girl's parents asked about a surgery that could preserve menstruation and reproductive function. The multidisciplinary team consisting of Tatyana Pervunina, Director of the Institute of Perinatology and Pediatrics; Nadezhda Kokhreidze, Head of Adolescent Gynecology Department; Eduard Komlichenko, Deputy Chief for Oncology; Ilya Kagantsov, Head of Research Laboratory of Pediatric Surgery for Congenital Diseases; Mikhail Mosoyan, Head of Urology Department of with Robotic Surgery Course, Head of Robotic Surgery Centre, concluded that robotic surgery could be an option in this case.
The preliminary stage with the preparation of perineal tissues and psychological support was followed by a procedure to perform a robot-assisted intracervical anastomosis for the removal of menstrual blood in the most physiological way. Intraoperative endoscopic ultrasound navigation facilitated the procedure. The procedure was performed by six surgeons alternately. The robotic stage was performed by Mikhail Mosoyan and Eduard Komlichenko, assistant surgeons were gynecologist Vladimir Stasyukevich and urologist Dmitry Fedorov, Nadezhda Kokhreidze was responsible for navigation, vaginal stage and strategizing, Ilya Kagantsov was responsible for navigation and strategizing. It should be noted that only few such surgery cases have been reported in the world literature.
Almazov Centre implements a multidisciplinary approach for a variety of medical conditions. It is based on the work of competence centres that synthesize scientific, practical and technological advances both for solving scientific and practical problems and in general for the benefit of patients.
It is very important that people in Russia have the opportunity to receive world-class high-tech specialized care with minimum complications and best outcomes.