Sarasota Memorial Hospital and urologic surgeon Robert I. Carey, MD PhD FACS have been designated as the first and only Robotic Surgery Training Epicenter in Florida focusing on Robotic Complete Female Pelvic Floor Reconstruction for vaginal vault prolapse and urinary incontinence in women.
Dr. Carey and Sarasota Memorial were recognized by Intuitive Surgical as a center of excellence because of their expertise, superior patient outcomes and ability to teach best practices to future robotic surgeons learning how to perform robotic female pelvic floor reconstruction. It is one of just three programs across the nation to earn the distinction. As an official Epicenter training site for uro-gynecological procedures, Sarasota Memorial hosts surgeons from across the nation as they study specialized surgical techniques by observing Dr. Carey in action in the hospital ‘s da Vinci surgical suites.
“Dr. Carey has performed well over 2,000 major urologic and uro-gynecological procedures since he arrived in Sarasota in 2006, the majority of them robotically,” said David Patterson, executive director of Sarasota Memorial’s Surgery and Heart & Vascular programs. “Over the years, he has trained many surgeons how to perform robotic surgery for prostate cancer in men as well as complex robotic surgery for urologic reconstruction. It is his vast experience and expertise that continues to draw surgeons to Sarasota Memorial for training.”
Robotic uro-gynecological surgery is one of the most important breakthroughs in women’s surgeries in the past decade. More than 130,000 women undergo surgery for pelvic organ prolapse each year.
“Historically, many woman had transvaginal surgeries, which on average, required a second surgery in about a third of all cases,” Dr. Carey said. “With the techniques we employ in robotic sacrocolpopexy, we have reduced those complications and can offer women a comprehensive pelvic floor reconstruction with just one surgery.”
Perhaps more importantly, he said, robotic sacrocolpopexy can be performed without removing a woman’s uterus. When women present with severe pelvic organ prolapse (which occurs when their uterus, bladder, rectum and intestines slide or herniate into the vagina), they often are offered a hysterectomy as part of the repair.
“Hysterectomy may be appropriate if there is cancer in the uterus or if the woman is having abnormal bleeding,” Dr. Carey said. “But if the uterus is otherwise normal, women don’t have to have their uterus removed just for the sake of prolapse repair.”
To be considered a candidate for uterus preservation, women must have normal pap smears and normal pelvic ultrasounds. Dr. Carey recommends that uterus preservation be performed as part of a multidisciplinary evaluation with the patient’s primary gynecologist.
Robotic sacrocolpopexy also can be performed in the “salvage” setting, allowing women who have had failed previous attempts at repair undergo a subsequent repair robotically. “This is important as many women historically will fail their first attempt at prolapse repair,” Dr. Carey said.
Risk factors for female pelvic organ prolapse include, childbirth, advancing age, previous surgery such as hysterectomy, and in some cases just the results of lifting or other activity. Symptoms include chronic pain, discomfort, and dysfunction due to the bulge into or through the vagina. Women may also experience urinary incontinence, urgency and frequency of urination, as well as sexual and bowel dysfunction.
About Robert I. Carey, MD PhD FACS
Dr. Robert Carey earned his medical degree from the Medical College of Georgia, as well as a Ph.D in chemistry from the Massachusetts Institute of Technology. His residency training in surgery and urology, and a fellowship in robotic surgery, laparoscopy and endourology, were completed at the University of Miami in 2006. He has been awarded a National Institutes of Health Fellowship in the Department of Chemistry at Harvard University and has served as an assistant professor at the Institute of Organic Chemistry at the University of Lausanne, Switzerland, and University of Georgia. Dr. Carey has performed more than 1,000 robotic surgeries at Sarasota Memorial Hospital. He was an invited lecturer in robotic female pelvic floor reconstruction and robotic surgery for prostate cancer at the Masters in Robotic Surgery Course for the Society of Robotic Surgeons in 2013. Dr. Carey is currently a clinical associate professor for the Florida State University College of Medicine and serves as a consulting editor for the Journal of Robotic Surgery. He is a member of the American Urological Association Leadership Class of 2014. Dr. Carey’s office is located adjacent to the Sarasota Memorial Hospital at 1921 Waldemere Street, Suite 310.
About Sarasota Memorial Health Care System
Sarasota Memorial purchased the first of its three da Vinci robots in 2006 and today serves as the region’s leading referral center with three robotic surgery suites and nearly two dozen robotic surgeons who have performed more than 2200 robotic surgeries across a broad range of specialties – cardiac, thoracic, urologic, colorectal, bariatric, gynecologic and oncologic surgery.