Duke Health’s experienced surgical teams have a long track record of integrating robotic surgical techniques in gynecological procedures. These minimally invasive surgeries have lower risk and produce better outcomes, with less pain and faster recovery time than surgery through large incisions — factors particularly important for patients who may be preparing for adjuvant therapy.
 
Six gynecological oncology surgeons with extensive expertise in robotic surgery offer less invasive therapy for patients at Duke Cancer Centers in Raleigh and Durham. Because surgery is usually the initial step in a series of treatments, successful outcomes and prompt recoveries are critical in accelerating care for patients with cancer.
 
“If you have a surgery that you can recover from faster because you have less insult to your body, then you’re going to feel well enough to tackle adjuvant therapies sooner. Faster surgical recovery can mean overcoming cancer sooner,” says Emma C. Rossi, MD, the newest member of the Duke gynecological oncology surgery team.
 
Approximately 85% of the surgeries Rossi performs are performed robotically. The procedures include radical hysterectomy, lymphadenectomy, sentinel lymph node biopsy, and cytoreduction. “Robotic surgery allows me to perform more complicated procedures with the minimally invasively technique than I otherwise could have,” she says.
 
Rossi emphasizes that the best outcomes come from centers where experienced surgeons have a record of performing a high volume of the robotic procedures.
 
“Volume matters,” Rossi says. “It’s important for providers to refer patients to a surgeon who has a high volume of experience and who has had more practice in robotic techniques. Data show these things impact outcomes and the likelihood of success.”
 
Because additional therapy following surgery is common for patients with cancer, Rossi says Duke’s collaborative approach among referring providers and cancer specialists is important in helping ensure continuity of care for these patients.
 
“We circle back after every new patient visit to let the referring provider know the diagnosis, the surgery recommended, and the timeframe for initiating that surgery so they have confidence that their patient is being taken care of in an expeditious fashion,” she says. “After the surgery, the same kind of communication continues with the referring provider to discuss the outcome and ongoing treatment recommendations.”

As a leader in the field of robotic surgery, Duke surgeons use the latest robotic surgical technology available; the surgeons also take an active role in shaping future robotic surgical innovations.
 
Rossi led the first-in-human trial of robotic-assisted sentinel lymph node mapping that has become standard for staging of endometrial and other gynecologic cancers. She will continue her research at the Duke Cancer Institute and will focus on exploring the potential of robotic surgery with near-infrared fluorescence imaging—paired with fluorescent markers—for mapping cancer.
 
Additionally, Rossi will be involved in a large, national clinical trial investigating the safety of robotic surgery to treat cervical cancer. The only cancer program in North Carolina participating in the randomized study, Duke will offer select patients an opportunity to have minimally invasive surgery rather than traditional surgery to treat cervical cancer. Inclusion in the study, says Rossi, is a testament to the team’s surgical expertise.
 
“Only very experienced robotic surgeons who've had large case numbers, a vast amount of experience, and demonstrated expertise with the procedure are included as part of this study,” she says. “We hope to enroll patients this summer.”