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Robotic Uterine Removal Surgery

Robotic assisted hysterectomy is a type of surgery that uses controlled robotic equipment to remove your uterus. Hysterectomy is the surgical removal of the uterus. The uterus is a hollow, muscular organ located in a woman's pelvis.

Having a hysterectomy ends menstruation and the ability to become pregnant. Depending on the reason for the surgery, a hysterectomy may also involve the removal of other organs and tissues, such as the ovaries and/or fallopian tubes.

The robotic assisted surgical system consists of two separate equipment. A piece of robotic equipment is located next to the patient in the operating room. This robot piece has four arms, which are long thin tubes attached to a thin surgical instrument or a small camera. Surgical instruments and camera enter the patient's body through small inch cuts (incisions) in the abdomen. A short distance from the operating table, the surgeon sits in front of separate computerized equipment that looks like a video game. The surgeon controls the movements of the robotic arms and instruments with hand controls. The surgeon looks through the binocular-like lenses on the equipment, and a computer creates a three-dimensional view of the operating field. Foot pedals control the camera and allow the surgeon to zoom in or out to change the surgical image.

How does robotic assisted surgery help the surgeon?

Robotic assisted surgery is a computer-assisted surgical system that provides surgeons with the following advantages:

  • 3D view of the surgical field at up to 15 times the depth, magnification and high resolution
  • Instruments that mimic the movement of the human hand, wrists and fingers and allow a wide range of motion that is more precise than the surgeon's natural hand and wrist movements
  • Constant fixation of robot arms and instruments and robot wrists that surgeons will have to work on organs and tissues for a long time and have difficulty reaching with human hands and fingers from angles and positions

The surgeon controls every precise movement of the robotic arms and instruments. Robotic arms cannot move on their own.

Who can benefit from robotic assisted hysterectomy?

Robotic assisted hysterectomy can be particularly helpful in the following situations:

  • Patients who are obese
  • Patients with endometrial cancer
  • Patients with complex surgical cases, such as patients with advanced endometriosis or pelvic adhesions (scar tissue connecting nearby organs)

You and your surgeon will discuss whether robotic-assisted surgery is appropriate for your situation.

What happens before and during robotic assisted hysterectomy?

Before processing

Before surgery, your doctor will perform a physical exam, order blood and urine tests, and other tests to check your general health. Your doctor will tell you which of your current medications will continue to be taken and which should be stopped temporarily before surgery. You will be given instructions on when to stop eating and drinking the evening and morning before your surgery. Your surgeon will explain the procedure in detail, including possible complications and side effects. He will also answer your questions.

Surgery day

  • Urine catheter can be inserted to empty your bladder
  • Your abdomen will be cleaned with a sterile solution.
  • An intravenous (IV) catheter will be inserted into a vein in your arm to deliver medications and fluids.

During the procedure

After receiving anesthesia, your surgeon will make four or five small surgical incisions (incisions) in your abdomen (stomach). Thin surgical instruments and small lighted camera attached to the arms of the surgical robot are placed in the abdomen through these incisions. While sitting at the computer console, the surgeon controls the precise movement of the robotic arms, surgical instruments and camera. Members of the surgical team stand by the operating table to replace robotic instruments and provide further assistance to the surgeon as needed. Your surgeon usually removes the uterus from the vagina, as when delivering a baby. In some cases, the uterus is removed through small incisions in your abdomen. An anesthesiologist monitors your anesthesia and vital signs throughout the surgery

How long does it take to complete a robotic assisted hysterectomy?

Robotic assisted hysterectomy takes one to four hours to complete, depending on the surgeon and the complexity of the surgery.

What is the typical recovery time with robotic assisted hysterectomy?

Robotic hysterectomy is an inpatient treatment method. You may stay in the hospital overnight, but some women are discharged the same day. You can return to light regular activities the next day (walking, eating, climbing stairs). At your doctor's discretion, you can drive in about a week or less and be back to exercising in about four to six weeks. Your doctor will review your progress and tell you when you can return to your normal activities.

What are the advantages of robot-assisted surgery for patients compared to traditional open surgery?

Compared to traditional open surgery, the benefits of robot-assisted surgery may include:

  • Less blood loss during surgery
  • Smaller incisions with less scarring. The surgery is done with small incisions instead of a large open surgical incision.
  • Less pain after surgery
  • Reduced risk of infection
  • Shorter hospital stay
  • Shorter recovery time and faster return to previous activities. You can usually resume normal activities as soon as you feel comfortable.

What are the risks of robotic hysterectomy?

Robot-assisted hysterectomy takes more time compared to other methods of hysterectomy, such as traditional open hysterectomy performed by a surgeon. Longer surgeries can increase your risk of complications.

Like any surgical procedure, robotic hysterectomy carries some risks:

  • Bleeding
  • Damage to the bladder and other nearby organs
  • Infection
  • Anesthesia-related problems
  • Blood clots that form in the legs and can travel to your lungs

What is the prognosis (future) for people who have had a robotic hysterectomy?

Most women recover from a robotic hysterectomy in less time and with less pain compared to traditional hysterectomies. Because the incisions are small, people can return to their daily activities more quickly. With the exception of hysterectomy for cervical cancer, robotic surgery outcomes are as good as open surgery with short recovery. Robotic surgery is not recommended for hysterectomies for cervical cancer, as cancer-related outcomes are significantly worse.

When should I call my doctor?

If you have had a robot-assisted hysterectomy and you develop any signs of complications, such as increased pain, bleeding, or fever, contact your doctor immediately.

Robotic hysterectomy is not for everyone. Your doctor will determine if the procedure is right for you based on your diagnosis and needs and your personal health situation. For example, if you have a heart or lung condition that would prevent total sedation, robot-assisted surgery would not be an option.

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