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Symptoms Lead to Unexpected Diagnoses

During her annual exam with her gynecologist, Leslie Badami talked about the abnormal vaginal bleeding she was experiencing. “I was nearing menopause and was having intermittent spotting throughout the month, even though I was on birth control pills,” Leslie said. “Because I wasn’t in pain, I didn’t think it was serious and waited a few months for my yearly exam to discuss it with my gynecologist.”

After her exam, Leslie’s doctor scheduled a short procedure to diagnose the cause of the bleeding and found a malignant tumor on the endometrial wall of Leslie’s uterus.

When she heard the word, “cancer,” Leslie remembered feeling her stomach sink. “My mom was diagnosed with vulvar cancer in her fifties, and it was scary receiving the diagnosis.”

Leslie’s gynecologist referred her to Dr. Al Elbendary, a Missouri Baptist Medical Center surgeon who specializes in gynecologic oncology and robotic-assisted surgery using the da Vinci surgical system.

“When I met with Dr. Elbendary, he told me that I had an aggressive tumor and was a candidate for robotic-assisted surgery to remove the cancerous mass,” Leslie said.

A Less Invasive Procedure

Unlike traditional “open” surgery, where surgeons make one larger incision through skin and muscle, robotic-assisted surgery is a less invasive procedure with four or five small incisions less than one inch each. The surgeon inserts micro-instruments and a camera through the incisions and sits at a nearby computer console to control the instruments while seeing high-definition images of the anatomy.

“Although not every patient is a candidate for robotic surgery with the da Vinci surgical system, it offers benefits over traditional techniques,” Dr. Elbendary explained. “We see fewer complications, and patients typically recover quicker with less pain than with open procedures.”

On February 20, 2018, Leslie had robotic-assisted surgery to remove her uterus (hysterectomy), ovaries, fallopian tubes and lymph nodes. “Before this surgery, I never had abdominal surgery and didn’t know what to expect,” Leslie said. “Dr. Elbendary answered all my questions, his experience put my mind at ease and the office staff made me feel like I was one of the family.”

After the surgery, Leslie spent a night at MoBap and was discharged home the following day. “I was sore after the operation but recovered fast and returned to fulltime work within four weeks,” she said.

Because cancer hadn’t spread outside of her uterus, Leslie didn’t need chemotherapy or radiation. She returns to MoBap once a year for x-rays to make sure she remains cancer-free.

Making A Choice

Rosa Bahr also found she was a candidate for robotic-assisted surgery when her gynecologist referred her to Dr. Elbendary.

“I went to see my gynecologist because I was experiencing pelvic pain and numbness when sitting,” Rosa said. “I thought I had sciatica.”

After an examination, her gynecologist ordered testing which revealed a mass around her ovaries. He referred Rosa to Dr. Elbendary for surgery.

“In the past, I had bariatric surgery and my gallbladder removed through traditional, open techniques,” said Rosa. “I had a lot of pain and long recoveries after both procedures.”

During her consultation, Dr. Elbendary explained the benefits of faster recovery time, smaller incisions and the potential for less pain with the da Vinci robotic system.

“The minimally-invasive approach and benefits with the da Vinci procedure helped me decide that it was the surgery I wanted,” Rosa recalled.

Even though robotic-assisted surgery has become more mainstream over the past ten years, Dr. Elbendary meets patients who have misconceptions about the technique. “When patients hear the word ‘robot,’ they sometimes think a machine or a computer is performing the operation,” he said. “But the equipment doesn’t do anything on its own. The da Vinci surgical system is controlled by the surgeon, and it relies upon the surgeon’s skill and expertise.”

Dr. Elbendary removed Rosa’s fallopian tubes and ovaries with the masses and released adhesions (bands of scar-like tissue that cause organs and tissues to stick together). She was discharged home the same day.

“In comparison with my previous surgeries, I had minimal pain with the robotic-assisted surgery,” Rosa said.

Early the next week, she received news that the masses on her ovaries were benign cysts, and she didn’t need further treatment.

Rosa is grateful for the care she received at MoBap and from Dr. Elbendary. “The staff at Dr. Elbendary’s office were amazing,” she said. “Dr. Elbendary made me feel comfortable with the procedure, which I appreciated.”

Smooth Recoveries

“Even though we perform the procedure through small incisions, it’s important to realize that robotic-assisted procedures are still considered major surgery with risk of complications,” Dr. Elbendary said.

Looking back on their experiences, Leslie and Rosa are glad that they had surgery with the da Vinci technology.

“I was able to get back to my normal activities quickly,” Rosa said. “If I had a traditional, open surgery, my recovery would have been longer.”

Leslie agreed and added, “I have minimal scarring. Dr. Elbendary’s surgical skills with the da Vinci technology and the team at MoBap were amazing.”

If Leslie could change one thing about her experience, it would be to contact her gynecologist earlier to discuss the abnormal bleeding. “Trust your instincts,” she advised. “If something seems wrong, get it checked out and don’t ignore a possible problem.”

Rosa concurred, “Also, rely on your doctors. I feel fortunate that my gynecologist referred me to Dr. Elbendary for treatment.”

A New Milestone Reached

Dr. Elbendary has devoted his career to treating gynecologic cancer and other gynecologic conditions. In October 2019, he was recognized for performing his 500th robotic surgery case using the da Vinci surgical system. Because most gynecologists don’t have a large surgery volume, this number is considered rare for his specialty.

Dr. Elbendary is grateful that he can make a difference in patients’ lives. “Ten years ago, if someone had told me that we would be doing robotic surgery and achieving the outcomes we observe today, I wouldn’t have believed it possible,” he said. “I’m excited to see the progress being made with surgical technology, which helps make for an improved patient outcome and experience.”