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What is Robotic Assisted Gynecologic Surgery?

Robotic assisted gynecologic surgery is a minimally invasive surgical technique used to treat and repair various gynecologic conditions with the aid of a robotic operating system such as the da Vinci robotic system.

The da Vinci Surgical System is a robotic tool that offers improved magnification and viewing of the surgical site and greater precision that helps surgeons to make small, precise surgical cuts to carefully remove tissue while preserving structures of the internal female reproductive system, such as the uterus, ovaries, fallopian tubes, cervix, and vagina.

Due to the advancement in medical science and technology, the field of robotic surgery has developed exponentially and has broadened the scope of minimally invasive gynecological surgery, compelling gynecologic surgeons to consider robotic-assisted gynecologic surgery for various gynecologic conditions, such as uterine cancer, uterine fibroids, endometriosis, uterine prolapse, and menorrhagia (excessive bleeding).

Indications and Contraindications for Robotic Assisted Gynecologic Surgery

Today, robotic technology has been widely indicated to perform a variety of gynecological procedures, including:

  • Hysterectomy for gynecologic cancer
  • Myomectomy for removal of fibroids from the uterus
  • Sacrocolpopexy for treating pelvic organ prolapse
  • Adnexal surgery for removal of cysts, tumors, or adhesions in the uterus
  • Malignancy staging
  • Lymph node dissections

Any woman who is fit and healthy is a suitable candidate for robotic assisted gynecologic surgery; however, it may not be appropriate for everyone. Robotic assisted gynecologic surgeryis contraindicated in patients with:

  • Bleeding disorders
  • History of previous surgery
  • Pregnancy
  • Cardiopulmonary diseases

Procedure for Robotic Assisted Gynecologic Surgery

Most of the complex gynecologic surgical procedures can be performed with the da Vinci robotic system. The da Vinci® robotic surgical system offers a minimally invasive alternative option to traditional open and laparoscopic surgery.

The da Vinci® surgical system consists of a surgeon’s console, a patient-side cart with four interactive robotic arms, a high-performance vision system (3D camera), and miniaturized Endo Wrist surgical instruments.

While performing the surgical procedure, your surgeon will be seated at the da Vinci® console and is able to view a magnified, high-resolution 3D image of the area to be operated. To access the surgical site, your surgeon introduces miniaturized EndoWrist instruments through a few tiny incisions. These instruments help your surgeon perform the procedure with precision and control. Your surgeon uses master controls that function similar to forceps and in turn da Vinci® responds by immediate translation of the surgeon’s directions into precise movements of miniaturized instruments.

Postoperative Care and Instructions

Post-procedure care and instructions for robotic-assisted gynecologic surgery will include the following steps:

  • You will be transferred to the recovery area where you will be asleep until the anesthesia wears off.
  • You may notice some pain in the pelvis or abdomen area once you gain consciousness. Pain medications will be prescribed to alleviate pain.
  • You may notice mild to moderate bloating for some days as a result of anesthesia and surgery. Anti-gas medications will be prescribed to relieve the discomfort.
  • You will feel some discomfort and increased fatigue as a result of surgery. You are advised to eat a healthy diet and drink lots of water to speed up the healing.
  • Refrain from strenuous activities and heavy lifting for a couple of weeks.
  • Strict adherence to prescription medications is advised. Do not abuse opioid medications prescribed for pain.
  • Refrain from sexual activity for at least 6 weeks if you have undergone a hysterectomy.
  • You can usually return to work in a couple of weeks unless your work involves strenuous activity or heavy lifting, in which case, it is advised to wait for 6 weeks.
  • Adherence to scheduled follow-up appointments to monitor your progress.

Benefits of Robotic Assisted Gynecologic Surgery

Gynecologic surgery with a robotic system offers several benefits over the traditional surgery, including:

  • Less pain
  • Low risk of wound infection
  • Less blood loss
  • Less scarring
  • Shorter hospital stay
  • Faster recovery
  • Fewer complications
  • Fewer requirements in blood transfusions

Risks and Complications of Robotic Assisted Gynecologic Surgery

Robotic assisted gynecologic surgeries are relatively a safe option for treating gynecologic conditions; however, it does have some risks associated with it, such as:

  • Mechanical malfunction
  • Damage to nerves, vessels, and adjacent organs
  • Bleeding
  • Infection
  • Internal burn injuries
  • Potential human error in operating the robotic technology

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