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Our Services / Gynecological Services

Minimal Access Surgery

Throughout the last century, surgeons have strived to improve their treatment outcome thus providing better and advanced care to patients by technological innovations and adaptations from other scientific fields. The best example is the introduction of laparoscopy which was first performed by Dr. Hans Christian Jacobaeus of Sweden in 1910 (thoracoscopy). This technological advancement has the potential of reducing pain and scarring associated with open laparotomy.  But it took many years for the technology to evolve. In 1975, Tarasconi, from the Department of Ob-Gyn of the University of Passo Fundo Medical School (Passo Fundo, RS, Brazil), performed the first organ resection by laparoscopy (salpingectomy).  This laparoscopic surgical procedure was the first laparoscopic organ resection reported in the medical literature. In 1981, Dr. Kurt Semm did the first laparoscopic appendectomy as well as the first laparoscopic assisted vaginal hysterectomy ( LAVH). He was a true pioneer in the field of MIS by developing thermocoagulation (Roeder Loop) to stop bleeding, electronic insufflator and the technique of intra and extra corporal endoscopic knotting. In 1985,Muhe did the first laparoscopic cholecystectomy and by the 1990’s laparoscopic procedures became the standard for appendectomy, cholecystectomy, oophorectomy and tubal ligation.

But there were multiple limitations to laparoscopy especially the lack of three dimensional view, loss of haptic feedback, restricted degrees of freedom, etc., that prevented the technology from being used in complex surgeries like vascular surgery, microsurgery, etc.  In the early 1990’s, major advances in computational sciences and microelectronics gave way to the development of robotic surgery. Many industry leaders like IBM, SRI international, JPL, Imperial College London, NASA and MIT,all working around the same time period, identified opportunities in the application of robotic technology to overcome the limitations of conventional laparoscopy. This lead to the development of many robotic surgical systems.


At The Center for Reproductive Medicine and Robotic Surgery(CRMRS) we provide private, professional and compassionate fertility care. Dr. Jacob and our reproductive team provide a very personalized approach, from diagnostic assessment and early intervention through high-tech procedures like In Vitro Fertilization (IVF), and Intracytoplasmic Sperm Insertion (ICSI), intrauterine insemination (IUI) and Pre-Implantation Genetic Testing – Aneuploidy (PGT-A).

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