Minimally invasive robotic surgery is one of the preferred options for patients who require surgical intervention that enables surgeons to better visualize and more precisely perform highly technical laparoscopic procedures than would otherwise be possible. It ensures patient safety without affecting women’s fertility or chances of pregnancy. Advantages of minimally invasive robot-assisted surgery include less scarring, less bleeding, less pain and quicker recovery.
Robotic surgery is an evolution of laparoscopic surgery with some minor differences. During laparoscopic surgery, the surgeon makes small incisions on the patient’s abdomen which allow for insertion of the camera as well as the operating instruments which are used to perform the surgery. These tools move in up/down directions only.
On the other hand, robotic surgery includes a camera arm and mechanical arms with surgical instruments attached to them. The surgeon controls the arms while seated at a computer console near the operating table. The console gives the surgeon a high-definition, magnified, 3-D view of the surgical site.
Control of the instruments in robotic surgery is better than in traditional laparoscopy because the instruments in robotic surgery can move in any direction that the surgeon’s hand can move. This better control means the surgeon can perform more precise movements and speed up or slow down hand movements, and it allows for easy suturing and knot tying.
There are many gynecological operations that have shifted from traditional surgery to laparoscopic surgery and then to robotic surgery, as determined by the treating physician and surgeon, ranging from simple hysterectomy to more complex pelvic surgeries with severe endometriosis.
In addition, robotic surgical systems have been used to perform surgery for endometrial, cervical cancer and ovarian cancer that involve the removal of metastatic tumors.
About 90 percent of gynecological surgeries can be performed by the minimally invasive approach (laparoscopic or robotic). Large and complex operations require a robot because it gives us very accurate results.
Robot-assisted surgery is used in the removal of uterine cancer, along with the ovaries and lymph nodes, in case the tumor has spread, depending on the tumor size and how far it has spread. It is noteworthy that most patients who undergo this type of surgery are elderly, and therefore, they have lower pain tolerance and higher risk of postoperative complications, hence, this type of robotic surgery is considered safer for them.
Robotic myomectomy, a type of laparoscopic myomectomy, is a minimally invasive way for surgeons to remove uterine fibroids while leaving the uterus intact, thereby preserving the possibility of future pregnancy. A uterine fibroid is a common type of benign tumor that develops within the uterine wall. Uterine fibroids occur in 20-40% of all women during reproductive years. If a woman suffers from endometriosis, robot-assisted surgeries can help in the management of symptoms by eliminating scar tissue and removing endometrial implants. This type of surgery offers the physician the dexterity inside the abdomen to safely and accurately remove adhesions that are harder to extract with traditional surgery.
Robotic hysterectomy surgery removes all or part of a woman’s uterus and is one of the most common operations that require robotic intervention, especially if the woman had a caesarean section, which causes the presence of uterine adhesions. Robot-assisted prolapse repair has been also successfully performed, with the exception of some cases. In the past, all of these surgeries were performed in the traditional way, which required a large incision in the abdomen.
The benefits of minimally invasive surgery include fewer complications, such as surgical site infection, less pain and blood loss, quicker recovery and smaller, less noticeable scars. Robot-assisted surgery is performed through tiny incisions of one to two centimeters that cause minimal impact to the surrounding area. Patients are often able to go home after a very short hospital stay, and many women report little or no significant pain after surgery. The faster recovery time allows them to return to their daily activities in a matter of days.