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Robotic surgery technology assists women in carrying their pregnancies

Robotic surgery technology introduced in Southern Nevada a year ago is helping women carry their pregnancies and give birth safely.

Fewer than 10 procedures have been performed at Summerlin Hospital, but all cases have been either successful or the pregnancies remain viable, says Dr. Darin Swainston, an OB-GYN who has done the procedures assisted by a perinatologist, an OB-GYN that deals with high-risk pregnancies.

The special medical care introduced at Summerlin Hospital is part of the mosaic of medicine in Southern Nevada where hospitals offer specialized care that together add up to many services and procedures seen in other major metropolitan areas across the country. Whether it’s a Level 1 trauma center and burn center at UMC, pediatric heart procedures at Sunrise Children’s Hospital and other procedures and services unique to the valley’s hospitals, the list of medical care is growing.

The push for helping women with troubled pregnancies keep their babies started more than a year ago when perinatalogist Alan Bolnick approached Summerlin Hospital officials about bringing better technology to Las Vegas for patients because a traditional cerclage didn’t help them maintain their pregnancy beyond 19 to 23 weeks, Swainston said.

A traditional cerclage is a purse-string stitch placed vaginally on the part of the cervix that’s visible. It’s looks like a little button and there’s not a lot of tissue at the entrance to the womb, Swainston said.

“The cervix is 4 to 5 centimeters long, so you’re really trying to do this purse-string stitch at the very opening, and that’s why they’re not always successful because the top of the cervix can still fail,” Swainston said. “These patients can have the lower part of the cervix open up and they lose their pregnancy.”

For most women, a vaginal cerclage works. But in troubling cases where women have lost pregnancies or they had there cervix removed because of cervical cancer, they need a more complex procedure called the abdominal cerclage, requiring the robotic technology, Swainston said.

“You go in abdominally and you put the cerclage at the bottom of the womb and the top of the cervix,” Swainston said. “It’s placed at the highest level of the cervix and lower level of the womb. It’s a permanent stitch and it’s done robotically so we can do it minimally invasively and so we can do this on pregnant women. It’s left in and a C-section is done at the end of the pregnancy. We don’t take it out, so they can use it for future pregnancies.”

Swainston credits Summerlin Hospital and Bolnick for taking the lead on bringing the procedure to the valley. The two doctors traveled to receive training and got assistance early on from a physician from Detroit who had performed the procedures in the past. Summerlin already had the robotic technology in place, he said.

UMC is home to Nevada’s only Level 1 trauma center, one of fewer than a dozen in the nation to have its own freestanding center. It also has the state’s only pediatric trauma center, said Gregg Fusto, UMC’s chief nursing officer.

The freestanding center with 11 beds is designated Level 1 because that’s considered the mark of providing the highest level of care staffed 24 hours a day with emergency physicians, anesthesiologists and even subspecialists available on call. By the time patients arrive, they can be in the operating room within three minutes.

UMC has the only transplant center in the state. It does kidney transplants only but plans to do pancreas and liver transplants by 2015 once it hires a nursing director and ramps up, Fusto said. Other organs could be added in the future.

UMC has the only burn care center in the state and serves 10,000 square miles, covering parts of California, Arizona, and Utah.