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What is Robotic Hysterectomy?

Robotic hysterectomy is a surgical procedure to remove the uterus, either partially or completely. It is performed using robotic surgical instruments that are designed specifically to be controlled by a computer which is operated by the surgeon. This means that the robotic instruments are used by your surgeon under computer guidance to ensure the procedure is carried out with the utmost precision.

What are the Indications for Robotic Hysterectomy?

Robotic hysterectomy surgery is considered only after non-surgical approaches have been unsuccessful in treating gynecological problems.

Robotic hysterectomy is recommended for the treatment of certain female reproductive system disorders. These may include:

  • Fibroids: non-cancerous tumors in the uterus
  • Endometrial or uterine cancers
  • Uterine prolapse
  • Endometriosis
  • Chronic conditions:
    • Pelvic pain
    • Abnormal uterine bleeding

Pre-Surgical Preparation for Robotic Hysterectomy

Before scheduling your robotic hysterectomy, your surgeon will examine your complete health condition and lab reports. You will be given certain instructions to follow till the date of your surgery. You will have certain dietary restrictions. You should take your previous medications as per your surgeon’s instructions. You will also be advised to quit smoking if you do smoke and perform regular exercise.

Robotic Hysterectomy Procedure

The steps involved in a robotic hysterectomy surgery include:

  • You are placed in the supine position with your legs apart and the knees slightly raised at a specific angle. The angles are determined by your surgeon at the time of surgery.
  • An intravenous line or IV is started. You may be given antibiotics through the IV to decrease the chance of infection.
  • General anesthesia is administered to induce sleep and block pain sensations.
  • A breathing tube is introduced via your mouth and inserted down your throat to help you breathe during the operation.
  • Your surgeon makes a small incision near your belly button.
  • A plastic tube called a “port” is inserted through this incision to pump carbon dioxide gas into your abdomen. The gas inflates your abdomen and allows better visibility of the internal organs. It also creates more space to insert and move the surgical instruments during the surgery.
  • After your abdomen is inflated, a high-definition camera is inserted into this port.
  • Your surgeon will make additional port incisions for the robotic instruments.
  • A physician assistant will insert all the robotic tools through these ports.
  • Unlike standard laparoscopic instruments, the robotic tools can rotate 360 degrees and have more flexibility.
  • Seated at a special console, your surgeon operates the robotic arms and the camera with joystick-like controls and foot pedals.
  • A computer will translate the exact movements of your surgeon’s fingers into precise movements of the surgical tools.
  • At the same time, aHD vision system will provide a magnified 3-D stereoscopic view of the surgical area.
  • Depending on your situation, your surgeon may perform any of the following:
    • Partial hysterectomy: Only the uterus is removed, and the cervix, fallopian tubes, and ovaries are left in place
    • Total hysterectomy: The uterus and the cervix are removed leaving behind the fallopian tubes and ovaries
    • Radical hysterectomy: In this procedure, your surgeon removes the uterus, cervix, fallopian tubes, ovaries, the upper part of the vagina, as well as nearby tissues such as the pelvic lymph nodes.
  • At the end of the surgery, the incisions are closed with dissolvable stitches, staples, or surgical tape and covered with bandages.

Post-surgical Care for Robotic Hysterectomy

Following a robotic hysterectomy, your breathing tube will be removed. You will be taken to the recovery area for post-op monitoring. You may be required to stay in the hospital for 2 to 5 days. or until you feel comfortable taking food and liquids without vomiting, and you can move around easily.

You may have some vaginal discharge and bleeding for several days after the procedure. You will be prescribed pain relief medications. You can return to your normal activity in about six weeks, but complete recovery may take longer. Walking is encouraged as soon as possible after the surgery. However, you should avoid strenuous exercise.

After the procedure, you will no longer menstruate or be able to conceive.

You will be scheduled to see your surgeon for the first few months after surgery for a follow-up recovery.

What are the Risks and Complications of Robotic Hysterectomy?

Some of the risks and complications associated with a robotic hysterectomy may include:

  • Heavy bleeding or formation of blood clots
  • Infection
  • Anesthesia side effects such as nausea and vomiting
  • Urinary incontinence: loss of bladder control
  • Vaginal prolapse: a condition in which the vagina protrudes from the vaginal opening
  • Chronic pelvic pain
  • Bladder or ureter injury
  • Painful intercourse
  • Early menopause if ovaries were removed

What are the Benefits and Advantages of Robotic Hysterectomy?

The numerous advantages and benefits of robotic hysterectomy include:

  • More accuracy and less chance of error
  • The surgeon can view the internal ‘hard to view” regions through robotic assistance
  • It is performed through smaller incisions which reduces blood loss
  • It is less painful due to the small incisions as compared to an open hysterectomy
  • It offers quicker recovery
  • Quicker discharge from the hospital
  • Minimizes risk of infection

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