The benefits of robotic hysterectomy

Robotic hysterectomies are an attractive option for patients experiencing difficulties with their menstruation or reproductive system, and want to have a procedure that facilitates their comfort and recovery – however, there are significant consequences to a hysterectomy that patients need to be aware of. Dr Ketankumar Gajjar, an expert gynaecologist, discusses the robotic hysterectomy process in this article.

What is a hysterectomy?

The womb is the muscular organ with a cavity in the middle where a fetus gestates, and the cervix is another organ that lies at the bottom of the womb, connecting it to the vagina and acts as a narrow passage for fluids, like menstrual blood and semen – and for some people, babies – to pass through. Hysterectomies are a major surgical procedure, of which there are two types of hysterectomy: a partial hysterectomy, which only removes the womb; and a total hysterectomy, which will remove both the womb and the cervix. There is a procedure where, at the same time, the ovaries and fallopian tubes can removed, called a bilateral salpingo-oophorectomy. The type of hysterectomy that is performed depends on the needs of the patient and the condition being treated.

The reasons a patient may need a hysterectomy are:

• uterine fibroids
• chronic, extreme pelvic pain
• cervical or uterine cancer that has not responded to alternative treatments, such as radiotherapy
• abnormal or particularly heavy menstruation
• uterine prolapse
• endometriosis

What happens during a robotic hysterectomy?

Hysterectomies are traditionally performed through the vagina, through the abdomen, or with a laparoscope with small incisions. Robotic hysterectomy is an evolution of a minimally invasive hysterectomy, where a surgeon pilots a robotic frame that is equipped with state-of-the-art tools and a high-definition, stereoscopic, thin camera, which are all inserted in five small incisions through the abdomen, each around 1cm long. Robots for surgery are designed to be highly precise and aren’t subject to any of the quivering or fatigue that humans are fallible to. Robotic hysterectomies are a good option for patients with complex cases, like pelvic adhesive disease, or with obesity. Robots have a range of motion that allows them to manoeuvre efficiently to perform a hysterectomy in constricted or intricate anatomy. Robotic hysterectomies are performed faster than traditional hysterectomies, and cause less scarring and less blood loss for the patient, hastening the healing process and minimising pain, post-surgery. The whole process takes between two to four hours, and patients are likely to spend one night in the hospital, with total recovery time projected at around four weeks. This is preferable to abdominal hysterectomies, as the recovery period can take twice as long, and patients may have to have a drainage tube for a couple of days.

There are some risks to consider, as with any surgery, such as complications that cause major blood loss, blood clots, infection, and organ damage (such as to the bladder).

What happens after a robotic hysterectomy?

Patients can be very happy with the results, as the hysterectomy would have treated heavy menstruation, fibroids and endometriosis, liberating them from pain and discomfort. However, there may also be a feeling of grief due to the loss of fertility, as a hysterectomy will result in the complete cessation of menstruation and reproductive ability. After a hysterectomy with bilateral salpingo-oophorectomy, the patient will go into menopause immediately as the hormone-producing gonads, the ovaries, are removed, resulting in menopausal symptoms like vaginal dryness and hot flashes, but these can be eased with hormone replacement therapy.

Though menstruation has stopped, there should be some light bleeding post-surgery, which can only be managed with pads, panty liners, or period underwear, as vaginal penetration – including tampons, moon cups, and sexual intercourse – heavy lifting, and intense physical activities should be avoided for up to five weeks. Moderate aching and pain are expected afterwards, and can be managed with painkillers procured either over-the-counter or as prescribed by the surgeon. Patients should not fully submerge themselves in water, either to bathe or swim, for at least two weeks, though they can shower after 48 hours.

If you are considering a hysterectomy, or are experiencing issues with your uterus or cervix, contact Dr Ganjjar today via his Top Doctors profile.