Edward Tanner, who joined Johns Hopkins in February as director of women’s health for the National Capital Region, treats gynecologic cancers as well as benign conditions such as fibroids and ovarian cysts, using minimally invasive and robotic techniques as often as possible.

Based at Sibley Memorial Hospital, he is working to expand the pool of patients eligible for minimally invasive gynecologic surgery, particularly for patients with large benign or cancerous masses, and patients with scarring from previous surgeries.

“With patients who previously have had surgery, someone may have told them that they had too much scar tissue for a minimally invasive procedure,” says Tanner.

“Many times, we can still operate laparoscopically or robotically. It’s a matter of having the experience, skill and commitment to take care of the patient in the best way possible for their circumstances.”

For larger masses, when a fully minimally invasive approach isn’t possible, he says, “We can use a modified approach — the surgery is performed minimally invasively, and then we remove the specimen through a smaller incision than would otherwise be possible with a fully open approach.”

The specimens are placed in a bag and deflated before removal, ensuring cancer cells do not spill into the body. 

Minimally invasive surgeries are better for most patients, Tanner notes. “They recover so much faster. In many cases, they can go home the same day, with much lower rates of complications and a faster return to normal activities.”

Tanner says another advantage of the minimally invasive technology is that he can more precisely target tumors, because robotic systems provide magnification and three-dimensional vision.

Patients are often referred from either primary care doctors or gynecologists following symptoms of abdominal pain or unusual bleeding, of if they’ve discovered a mass in their pelvic area, he says.

Though imaging tests provide some information about whether ovarian masses are benign or malignant, preoperative biopsies are usually not performed because biopsy can lead to rupture and spreading of cancer cells, Tanner says.

During surgeries, pathologists read the results while the patient is still under anesthesia, and additional procedures may be performed before waking the patient up. This is called a “frozen section.”

Tanner makes sure patients know what to expect during surgery. “We discuss a lot of possible outcomes because we don’t want to wake the patient up and operate multiple times,” he says. “We try to do everything all at once, and that’s an important reason why patients will see a gynecologic oncologist for surgery rather than their regular gynecologist.”

He also explores nonsurgical options when appropriate, for example with patients seeking information about a hysterectomy. “A big part of our job is to make sure that patients get to make an informed choice, especially if it’s not cancer,” he says.

In keeping with his push to minimize surgical interventions, Tanner is leading a large clinical study that is assessing whether sentinel lymph node mapping, in which lymph nodes are biopsied during surgery for uterine cancer, can reduce the risk of chronic leg swelling after surgery.

Tanner received his medical degree from the University of Alabama School of Medicine, and completed his Gyn/Ob residency at Johns Hopkins in 2008. Following a fellowship in gynecologic oncology at Memorial Sloan Kettering Cancer Center, he was on faculty at The Johns Hopkins Hospital from 2012 to 2018.

He is returning to Johns Hopkins after most recently serving as the Marcia Stenn Professor and Chief of Gynecologic Oncology at Northwestern University’s Feinberg School of Medicine in Chicago.

“I’m excited to be back,” Tanner says. “I’ve always enjoyed caring for women with complex medical issues, and as a gynecologic oncologist, I have a role in both the surgical and medical management of my patients. I stay closely involved in their care throughout their cancer journey.”

“There is really excellent care here at Sibley, and I think it’s wonderful for patients to be able to get exceptional care close to home.”