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Loudoun Gynecologist Pioneers New Procedure

© Leesburg Today - 05/28/2015

One of Loudoun's longest-serving gynecologists is performing cutting-edge work at Inova Loudoun Hospital.

Dr. Chauncey C. Stokes, chairman of the Department of OB/GYN at the hospital, is the first benign gynecologist to perform single-site robotic hysterectomies at the hospital. He also is one of only three obstetricians to perform the procedure in the entire Washington, DC, area.

Stokes began offering the single-incision procedures in January, and has already completed more than 15 operations with great success. Ultimately, Stokes says he is aiming for a target of at least 50 for this year. The procedure, using the hospital's da Vinci surgical system, promises great benefits for women needing to undergo a hysterectomy, as it is less invasive and significantly reduces recovery times.

Stokes' interest in the high-tech surgery comes after working more than 30 years in the field.

And, as his patients will attest, Stokes has a great capacity for compassion. ""I liked caring for people-that was a tremendous draw,"" he said. It's a draw that over 30 years has led to his involvement with a procedure that helps women in particular need.

Who Needs A Hysterectomy?

Women who need a hysterectomy include those with significant bleeding, fibroids and pelvic pain, and, of course, cancer, Stokes said.

The word comes from the hystera, the Greek word for womb. ""You can do a partial hysterectomy-removing just the uterus but leaving the ovaries,"" Stokes said. ""Or you do an ovariectomy, where the ovaries are removed as well. A salpingectomy takes the tubes-they're all connected, but the uterus is the organ that's bleeding.""

And the condition affects women differently, Stokes said. Some can keep hormonally stable-some are fine, others are miserable.

""We used to give estrogen, but now we consider the risk of breast cancer-we think it's low, but we can do it for a woman if she's miserable, irritable, has hot flashes and can't sleep.""

More challenging cases can last up to six years and women with thyroid problems have more difficulty, according to Stokes.

The Merits Of Robotic Surgery

There are two ways to perform a hysterectomy: laparoscopy, where the operation is performed with small incisions through the abdomen to exit via the vagina; or robotics, using the da Vinci robot through a single entry site.

Stokes said the value of the robotic gynecology surgery is that recovery is so much faster, particularly with single-site incisions. For active women, such as runners, ""They can be back at work in the second week in contrast to multi-incisions where [initial] recovery would take three to four weeks,"" Stokes said.

A recent patient agreed with him. A Round Hill woman said she was amazed at the speed of her recovery.

""I recovered faster than expected and had to force myself to slow it down. I was back to work in under 10 days,"" she said.

Technology In The Driving Seat

For surgeons, the procedure is ""like having your arm in a cast-you can move in angles, you move your arms rather than your hands. It gives more dexterity and flexibility,"" Stokes said.

""Technology is driving this, and will continue to do so,"" he said, noting high definition televisions are now put to use in the operating room.

""It's like having many eyes, much more magnification-and as the technology improves we'll be able to do more and more,"" Stokes said, noting the procedure was originally developed through the military.

In normal circumstances, the doctor has a console, he wears binoculars, and his hands manipulate the robot-the patient is usually six or seven feet away. The computer manages the magnification, lights and controls.

""The computer interprets what you do as the surgeon. If you move your hand to the right, it responds to what you are directing, in a natural way-it's not on auto pilot,"" Stokes said.

At age 60, Stokes says he prefers to concentrate on the surgical side.

""I'd like to see robotics in GYN evolve-that's my niche of interest,"" he said.

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