Robotic Hysterectomy

Hysterectomy is the medical term for surgery to remove a woman’s uterus. Depending on your medical need, your surgeon may also remove some reproductive organs near your uterus. Types of hysterectomy include:

• Partial hysterectomy, which removes the uterus, but leaves your cervix in place
• Total hysterectomy, which removes the entire uterus and cervix
• Hysterectomy with salpingo-oophorectomy, which removes the uterus, cervix, and one or both of your ovaries and fallopian tubes
• Radical hysterectomy, which removes the uterus, cervix, both ovaries, both fallopian tubes and, if necessary, the upper portion of your vagina and nearby lymph nodes

No matter what type of hysterectomy you have, you will no longer have a monthly period. And once your uterus is removed, you cannot get pregnant or carry a child. If you want to have biological children, talk to your doctor before your hysterectomy. He or she can refer you to a Scripps fertility specialist. You may be able to extract some of your eggs and store them for later use. Learn more about infertility and reproductive care at Scripps.

A hysterectomy causes menopause only when the ovaries are also removed.

Hysterectomy is a treatment option for many women’s health conditions. These include:

• Ovarian cancer
• Uterine cancer
• Cervical cancer
• Uterine fibroids
• Endometriosis
• Uterine prolapse
• Abnormal vaginal bleeding

In many cases, hysterectomy is one of several treatment options. You and your doctor should discuss which treatments are appropriate for you, including medications or other types of surgery.

Scripps offers the full range of hysterectomy procedures, including the latest minimally invasive techniques that may reduce pain and recovery time. These include: 

• Abdominal hysterectomy, which removes your uterus through a large cut (incision) in your lower abdomen. This incision may be vertical or horizontal, depending on the type of hysterectomy you’re having. 
• Vaginal hysterectomy, which removes your uterus through an incision in your vagina.
• Laparoscopic hysterectomy, which is a minimally invasive procedure that uses several tiny incisions (instead of one large incision). Your surgeon guides a thin, flexible tube mounted with a tiny camera through these incisions, so he or she can see inside your abdomen. The uterus is then removed through your vagina or one of the abdominal incisions.
• Robotic hysterectomy is nearly identical to laparoscopic hysterectomy. However, during robotic surgery, your surgeon doesn’t hold surgical instruments in his or her hands. Instead, the instruments are attached to robotic arms, which your surgeon controls from a nearby computer console. 
• Single-site robotic hysterectomy, which allows your surgeon to remove your uterus through a single, tiny incision hidden in your navel. 

Not everyone is a candidate for minimally invasive surgery. Your doctor will help you understand which surgical options are best for you.

All minimally invasive surgical procedures require fewer, or smaller, incisions. But robotic hysterectomy is different from laparoscopic hysterectomy. It uses robotic technology to increase precision and control.

During robotic hysterectomy, surgical instruments (and a tiny camera) are attached to robotic arms. These arms are controlled by a specially trained surgeon from a nearby computer console. 

As your surgeon moves his or her hand, wrist and fingers, the robotic arms perform the same movements in real time. Not only do the robotic arms mimic delicate movements, they can bend and rotate in ways a human hand cannot.

The computer console also displays a high-definition, close-up view of the surgical site. Throughout the procedure, your surgeon can see inside your body in three dimensions. This is another key difference – during laparoscopic hysterectomy, surgeons only have a two-dimensional view of the surgical field.

Depending on the type of robotic hysterectomy you’re having, your surgeon may remove your uterus (and other organs, if necessary) through your vagina, an abdominal incision or your belly button.

In most cases, women who have a robot-assisted hysterectomy can return home the day after surgery. You may be able to resume normal activity within two to three weeks. 

In comparison, women who have a traditional abdominal hysterectomy may need to stay in the hospital for several days following their procedure. And recovery can take six to eight weeks. 

Everyone recovers differently following surgery. Your recovery time will depend on several factors, including your age, overall health and the type of hysterectomy you had.

It’s important to check with your health plan before having any surgical procedure. Many, but not all, insurance companies cover robotic surgery (including robotic hysterectomy). Those that cover robotic surgery often categorize it as “robot-assisted minimally invasive surgery.” In most cases, if your plan covers minimally invasive surgery, it will also cover robot-assisted surgical procedures.

Like other minimally invasive procedures, robotic hysterectomy may offer several benefits. These include: 

• Less blood loss (reducing the need for a blood transfusion)
• Less pain (reducing the need for pain medication)
• Reduced risk of complications, including surgical site infection
• Smaller, less visible scars
• Shorter hospital stay
• Faster recovery

Like all surgery, robotic hysterectomy also carries risks. These include:

• Damage to nearby organs and tissue, including the urinary tract or bowel
• Long-term urinary problems, such as frequent urination or bladder leakage
• Vaginal shortening, or scar tissue in the vagina
• Early introduction of menopause, even if your ovaries weren’t removed
• Excessive bleeding
• Surgical site infection 
• Complications from anesthesia
• Equipment failure