Surgical removal of a woman’s uterus, known as a hysterectomy, is a common procedure used to treat several gynecologic conditions. By age 60, more than one third of women in the United States will have had a hysterectomy.
Conventional hysterectomy surgery requires a large incision across the abdomen and a lengthy recovery period, but minimally invasive surgical techniques have made the procedure and recovery easier, and robotic technology offers even more advancements. San Diego Health host Susan Taylor talks with Kim Hui, MD, an OB-GYN at Scripps Clinic Hillcrest, about the advantages of minimally invasive robotic hysterectomy.
There are different gynecologic conditions that require a hysterectomy.
Hysterectomy is a common treatment for uterine cancer (also known as endometrial cancer) or cervical cancer that has spread to the uterus, but it also may be recommended for noncancerous conditions. If a woman has endometriosis, a painful condition that develops when the uterine tissue grows outside of the uterus, a hysterectomy may be the best option. Fibroids, which are noncancerous tumors that form in the muscle layers of the uterus, may become painful and require removal of the uterus.
“We try to treat these ailments with conservative measures first, such as hormones and pain medications,” says Dr. Hui. “If those aren’t effective, that’s when hysterectomy comes in. Most of these patients are women in their 40s, who are done with childbearing.”
In a conventional or “open” hysterectomy, the surgeon makes a sizeable incision across the abdomen and removes the uterus through it. Bleeding may be significant, and most patients stay in the hospital for two days. Recovery can take six weeks or more.
Minimally invasive hysterectomy surgery (also known as laparoscopic surgery) uses just a few very small incisions, including one hidden in the belly button. The surgeon inserts a tiny video camera and thin surgical instruments through the incisions and, using images projected onto a video screen, performs the surgery. Laparoscopic surgery offers multiple benefits including less bleeding, fewer risks of complications, less pain and scarring and faster recovery time.
Robotic technology takes minimally invasive hysterectomy surgery even further. During robotic-assisted hysterectomy, the surgeon performs the procedure using robotic “arms” inserted into the surgical area through tiny incisions. The video images are much better: high-definition, three-dimensional video magnifies the surgical area up to 10 times larger than normal.
Guided by detailed video, the surgeon uses an instrument panel to control every movement the robotic arms make. At no time do the arms move on their own. Because they are robotic, the arms have much greater range of motion than human hands and wrists, giving the surgeon much more dexterity and control over the surgical instruments.
“With robotic-assisted hysterectomy, patients usually go home the same day,” says Dr. Hui. “They have less bleeding, less pain, and it just gives them a better experience.”
Recovery from robotic-assisted hysterectomy is typically two to three weeks; after that, most women can return to their usual activities, including exercise. Some patients return to work after just one week. Scarring is minimal. The incisions on either side of the belly button are small and below the bikini line.
Though it is less invasive and has a faster recovery period, robotic hysterectomy surgery is still surgery. As with any surgical procedure, the body needs time to rest, heal and recover. There are also risks of infection or complications, but these are lower with robotic surgery.
Dr. Hui encourages women who have endometriosis, pelvic pain or other concerns that are not being treated effectively to talk with their gynecologists about their options, including robotic hysterectomy.
“This procedure has come a long way, and it gives many women the ability to live their lives without pain,” she says. “Robotic surgery is specialized surgery, and Scripps surgeons have extensive training and experience in this technology.”