Robotic-Assisted Hysterectomy

A robotic-assisted hysterectomy (also called a robot-assisted hysterectomy) is when a surgeon uses a surgical robot to perform the steps of a hysterectomy. During this surgery, your surgeon controls the robotic arms from a console the entire time. They look at a screen that magnifies your internal organs instead of standing directly over you.

This approach may cause less pain and blood loss than open abdominal surgery. You may also recover faster.

What does it treat?

A hysterectomy is the surgical removal of your uterus. Your healthcare provider may recommend it to treat conditions like:

• Abnormal or heavy vaginal bleeding
• Severe and chronic pelvic pain
• Uterine fibroids
• Uterine cancer
• Uterine prolapse
• Advanced stage endometriosis

A robotic-assisted hysterectomy isn’t for everyone. This type of hysterectomy may be especially helpful if you have obesity or need complex surgery. You and your surgeon will discuss whether robot-assisted surgery is possible and appropriate for you.

What happens in a robotic-assisted hysterectomy?

A robot-assisted hysterectomy is a type of minimally invasive surgery. Your surgeon makes several small cuts (incisions) instead of one large cut in your abdomen. Then, they insert a laparoscope (a thin tube with a camera) and other surgical instruments through the incisions.

The laparoscope sends images of the surgery to a high-definition video screen. Your surgeon watches the screen to do the surgery. They control the surgical instruments from a computer console a few feet away from you. The instruments don’t move on their own.

On the day of surgery

You’ll arrive at the hospital or surgical center several hours before surgery. In the pre-operative area, a healthcare provider will place an IV in your arm. The IV will help your team give you medicine and fluids during surgery.

After you receive anesthesia and are asleep, your healthcare team will:

• Insert a catheter to empty your bladder.
• Clean your abdominal area with a sterile solution.
• Place your body in a slightly reclined position, similar to how you lie during a pelvic exam.

Steps of a robotic-assisted hysterectomy

In general, your surgeon will:

1. Make four or five small incisions in your abdomen to insert a scope and several small surgical instruments.
2. Control the robotic arms from a console.
3. Separate your uterus from the surrounding tissues, and remove it through your vagina or through an incision on your abdomen.
4. Close the incisions with stitches and cover them with bandages.

A robotic-assisted hysterectomy usually takes two to four hours. Most of the time, you go home several hours after surgery. But you may need to stay in the hospital overnight.

What are the advantages of robotic-assisted hysterectomy?

A robot-assisted surgery may give your surgeon several advantages, including:

• A closer, clearer view: The laparoscope provides a high-definition, 3D view of the area being treated. It can also magnify the area up to 15 times.
• More precise movements: The robotic instruments can move like your surgeon’s hands, wrists and fingers. This allows your surgeon to make precise movements in small or hard-to-reach areas.
• Steady movements: The robotic arms stay steady while your surgeon operates. This can make it easier to work on tissues and organs for long periods and reach areas that are hard to access.

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

• Less blood loss during surgery
• Smaller incisions with less scarring
• Less pain after surgery
• Lower risk of infection
• Shorter recovery and quicker return to previous activities

What are the risks of robotic-assisted hysterectomy?

Like any surgical procedure, a robot-assisted hysterectomy has risks, including:

• Bleeding
• Damage to your bladder and other nearby organs
• Infection
• Reaction to anesthesia
• Blood clots that form in your legs and can travel to your lungs

What is the recovery time for a robotic total hysterectomy?

The average recovery time after a robotic-assisted hysterectomy is about six weeks. You’ll likely be able to return to some light activities within 48 to 72 hours after surgery. It’s a good idea to have someone help you at home during this time. You may be sore and tired, and your activities will be limited.

You can usually drive within 72 hours, but this depends on what pain medication you’re taking. Most people can return to work after about two weeks. Your time away from work may be shorter or longer depending on what type of work you do.

Your surgeon will give you a list of activities to avoid after surgery. Some examples include:

• Don’t lift anything heavy (more than about 10 to 15 pounds) for at least six weeks.
• Avoid sex or placing anything in your vagina for at least six weeks.
• Use pads for vaginal bleeding, not tampons. You can expect to have light bleeding for several weeks.
• Keep your incisions clean and dry.
• Don’t take a bath or swim for six weeks. You may shower 24 to 48 hours after surgery, as long as you feel steady on your feet.
• Try to walk a little each day and gradually increase how long you walk.
• Avoid strenuous exercise for at least six weeks.

You may have mild menopause symptoms after a hysterectomy.

Your healthcare provider will check your recovery at your follow-up appointment and answer any questions or concerns you have.

When should I call my healthcare provider?

Contact your surgeon if you develop any of the following issues after a robotic-assisted hysterectomy:

• Redness, swelling, drainage or tenderness at the incision site
• Fever
• Excessive bleeding
• Trouble breathing
• Chest pain
• Pain that you can’t control with medication

Is robotic surgery better for a hysterectomy?

Robotic-assisted surgery isn’t necessarily better than other hysterectomy methods. The best option for you depends on your health, the type of hysterectomy you need and your surgeon’s experience. Your healthcare team can explain your options and the pros and cons of each.