Ph.D., is an associate clinical professor in minimally invasive gynecologic surgery at the Princess Royal University Hospital, in London, UK; a clinical lecturer at the Center for Experimental Surgery, European Center for Laparoscopic Training, University and Academy of Athens, Athens, Greece; and a consultant in gynecologic and minimally invasive surgery in Athens. He received his M.D. and his Ph.D. from Athens University Medical School and his M.B.A., with a specialization in health care management, from the Imperial College Business School, University of London, UK.
Dr. Chandakas, please describe the progress of minimally invasive surgical techniques in gynecology over the last 5 years. In what areas have we seen the most progress?Minimally invasive techniques have transformed women's surgeries in the past 5 years. Minimally invasive surgery (MIS) has rapidly moved from simple procedures done routinely in the early and mid-1990s, such as ovarian cystectomy and tubal ligations, to hysterectomies, fibroid removal, laparoscopic advanced pelvic-floor procedures, and procedures that are also done hysteroscopically, such as endometrial ablation, minimally invasive "tape" techniques, such as the transobturator approach for treating female stress urinary incontinence [TOT Tape, the Monarc™ system, American Medical Systems, Minnetonka, MN] and the Perigee™ and Apogee™ systems [also American Medical Systems]. We are rapidly moving to a combined technological and surgical evolution, which is typical of many specialties but is especially evident in gynecology. This will hopefully allow us, in the next 5-10 years, to be able to treat 95% of gynecologic pathology using minimally invasive techniques. By this I mean not only traditional laparoscopy and hysteroscopy but also a general approach toward less-invasive procedures, which will mean less hospital time for women, less trauma, and much better results.