Thirty years ago, if a woman had to have a hysterectomy, she had no choice but to undergo major abdominal surgery. This entailed a large incision and subsequent scarring, a several-day hospital stay, and a lengthy recovery period. However, since the first laparoscopic hysterectomy was performed in 1989, minimally invasive procedures have become increasingly common. Consequently, many patients can now opt for faster, lower-risk methods of surgery. Currently, doctors and researchers are exploring the potential of robotic surgery to provide better outcomes for patients who need a benign hysterectomy.

Minimally Invasive Alternatives To Abdominal Surgery

There are two standard types of minimally invasive alternatives to abdominal surgery for a benign hysterectomy: vaginal and laparoscopic surgery. Neither is recommended when large tumors need to be removed or when there is suspicion of invasive cancer. A benign hysterectomy, however, can be performed either through the vaginal opening or through very small “keyhole” incisions in the abdomen. Laparoscopy involves the insertion of a thin cable with a camera at the end to guide the procedure without requiring a large incision. The abdomen is inflated with carbon dioxide, an easily absorbed and vented gas, in order to provide a clear view. Vaginal surgery may be performed manually or with laparoscopic assistance.

Benefits Of Laparoscopic Surgery

The main benefits to the patient of laparoscopic and other minimally invasive procedures are shorter hospital stays, reduced pain, a lower risk of infection, less blood loss, less scarring, and a faster recovery time. Traditionally, abdominal surgery requires a two to three-day hospital stay, while laparoscopic surgery is frequently offered as an outpatient procedure. Because the incisions are very small, patients experience relatively little blood loss and have only minimal scarring afterwards. The small incisions also cause much less pain during the recovery period, allowing patients to resume normal activities much more quickly than with traditional surgery. The risk of infection is limited by the fact that the internal organs are only minally exposed to potential contaminants, and complications occur in only about 5% of patients.

Robotic Procedures

The latest development in minimally invasive surgery is the use of robotics technology to allow the doctor to operate remotely. A robotic surgical system has four main components: a control console where the surgeon sits, a cart with multiple interactive arms that hold surgical tools, an imaging system that provides a 3D view, and flexible tools that mimic the doctor’s hand movements via a computer interface. The robotic system is capable of performing all the functions of a surgeon and an assistant, including cutting, exploring, suctioning excess fluid, and suturing the incision. While the surgeon sits at the console some distance away from the patient, an assistant surgeon is present at the patient’s side to exchange tools as needed.

Benefits Of Robot-Assisted Surgery

As with other minimally invasive procedures, patients who undergo a benign hysterectomy via a robotic procedure benefit from a shorter hospital stay, less pain and scarring, and a faster return to normal activities. One of the particular benefits of a robotic surgical system is that it provides the surgeon with a wider and clearer view than he or she would be able to obtain through open surgery or a standard laparoscopic procedure. In addition, the technology allows the doctor to perform surgery without scrubbing in or risking potential contamination to the patient from an accidentally ruptured glove.

Recent Findings And Recommendations For Robot-Assisted Surgery

Up to now, studies have not demonstrated that robotic procedures provide better outcomes than standard laparoscopy. One factor that plays a significant role in the success of a robot-assisted procedure is the training and experience of the doctor. Researchers argue that the technology needs further study and that competency metrics and quality guidelines need to be established. While some doctors are eager to adopt cutting edge technology, others are waiting for more data to come in.

Thanks to the development of laparoscopic and robotic technology, the need for open surgery has been significantly reduced. Any patient whose gynecologist or ob/gyn recommends a hysterectomy should find out whether a minimally invasive procedure is an option.

For follow-up, contact Bedford Ob/Gyn doctors, Drs Mary Parker and Beverly Wood. These two ladies are extremely well trained, and have a compassionate way about them in helping ladies with their health concerns.