Robotic Hysterectomy –
A Minimally Invasive Surgical Option

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A hysterectomy is a surgical procedure to remove uterus which maybe necessary for various reasons such as fibroids , endometriosis , prolapse or cancers.

Traditional open surgery or laparoscopic surgery has been the common approach , but advancements in technology have introduced robotic hysterectomy as a minimally invasive option.

What is Robotic Hysterectomy ?

Robotic Hysterectomy is a minimally invasive surgery that utilizes a robotic system to assist the surgeon during the procedure.

This innovative approach combines the benefits of laparoscopic surgery with the precision and dexterity of robotic technology.

The Robotic system provides high –definition 3D visualization , precise dissection, and minimal tissue damage .

The surgeon controls the robotic arm from a console ,allowing precise movements and reduced fatigue.

Parts of a Robotic Setup

  • 1. Surgeon’s Console: The control centre where the surgeon sits and operates robotic arms.
  • 2. Robotic Arms: 3 or 4 robotic arms are inserted through small (8mm) incisions.
  1. one arms holds the camera
  2. two arms hold surgical instruments
  3. optional 4th arm for additional instrumentation.
  • 3. Endoscope (camera) : Provides high – definition 3D visualization of the surgical site.
  • 4. Surgical Instruments – they are attached to the robotic arm
  • 5 .Patient Cart
  • 6. Light Source
  • 7. Insufflator – maintains pneumoperitoneum
  • 8. Vision system : Shows the surgical site in real time
  • 9. Electrosurgical unit
  • 10. Uterine Manipulator

Robotic Systems used for hysterectomy is typically once of the following :

  • da Vinci Surgical System (Intuitive Surgical)
  • Robotic –assisted Surgical System (Medtronic)
  • Senhance Surgical System (TransEnterix)

Benefits of Robotic Hysterectomy

  • Less Invasive : This results in less tissue damage , less pain ,and faster recovery
  • Precise dissection
  • Shorter hospital stay
  • Faster Recovery
  • Less Blood loss
  • Reduced risk of complications

Candidates for Robotic Hysterectomy

  1. Endometriosis
  2. Adenomyosis
  3. Fibroid Uterus
  4. Uterine Prolapse
  5. Uterine cancers

Step by Step Overview

Preparation

  1. Patient preparation :General anaesthesia , positioning and preparation of pneuomoperitoneum.
  2. Robotic Set up : The robotic system is positioned and the arms are inserted through small incisions (about 1-2cm)

Procedure

  1. Docking : The robotic arms are connected to the surgical instruments and the endoscope (camera)
  2. Exploration : The surgeon visualizes the pelvic organ using high definition 3-D camera
  3. Uterine Mobilisation : The surgeon uses robotic arms to mobilize the uterus , freeing it from surrounding structures.
  4. Ligation of blood vessels
  5. Uterus Removal
  6. Vaginal cuff closure
  7. Hemostasis
  8. Undocking : The robotic arms are disconnected and instruments are removed.

Closure

  1. Pneumoperitoneum release
  2. Incision closure
  3. Patient recovery

CONCLUSION

Robotic hysterectomy is a minimally invasive surgical option that offers numerous benefits for women requiring a hysterectomy . With its advanced technology , precise dissection and reduced tissue damage , robotic surgery provides a faster recovery, less pain and fewer complications compared to traditional open surgery . The high definition 3-D visusalisation and ergonomic design of the robotic system enable surgeons to perform complex procedures with dexterity.

While robotic hysterectomy is not suitable for all patients , it has become an increasingly popular choice for many women . As technology continues to evolve , we can expect to see further advancements in robotic surgery making it even more effective and accessible option for patient worldwide.

Dr. Bhumika has been trained in Robotic Surgery. She has the distinction of performing the first Robotic Hysterectomy in Lucknow.