Total Robotic Hysterectomy

A total robotic hysterectomy is a minimally invasive surgery to remove the uterus (womb) and cervix using robotic technology (e.g., the da Vinci Surgical System). The surgeon controls robotic arms through small abdominal incisions, offering enhanced precision, less scarring, and faster recovery compared to traditional open surgery.

Why is it Performed?

Your gynaecologist may recommend this surgery for:

• Uterine fibroids causing pain or heavy bleeding.
• Endometriosis or adenomyosis unresponsive to other treatments.
• Gynaecological cancers (e.g., uterine, cervical, or ovarian cancer).
• Chronic pelvic pain or uterine prolapse.

Before Surgery

• Pre-operative tests:
  • Blood tests, imaging (ultrasound/MRI), or cervical screening.
  • Cardiac/pulmonary evaluation if needed.
• Preparation:
  • Fasting: No food/drink for 6–12 hours before surgery.
  • Bowel prep: May be required (follow your surgeon’s instructions).
  • Medications: Adjust blood thinners (e.g., aspirin) as advised.
• Arrange support: Plan for someone to drive you home and assist for 3–5 days.

During the Procedure

1. Anaesthesia: General anaesthesia (you’ll be asleep).
2. Incisions: 4–6 small cuts (0.5–1.5 cm) in the abdomen.
3. Robotic surgery:
   1. The surgeon controls robotic arms to detach and remove the uterus/cervix.
   1. Organs are removed through the vagina or in small pieces via the abdomen.
4. Closure: Stitches or glue seal the incisions.
5. Duration: 1–3 hours (varies with complexity).

Risks and Complications

• Common (temporary):
  • Shoulder/neck pain (from gas used during surgery).
  • Mild bloating, bruising, or vaginal spotting.
• Rare but serious:
  • Infection, bleeding, or damage to nearby organs (bladder, bowel).
  • Blood clots (deep vein thrombosis).
  • Conversion to open surgery (larger incision).
  • Early menopause (if ovaries are removed).

Recovery

In the hospital:

• Stay for 1–2 days (most go home within 24 hours).
• Catheter may remain temporarily to drain urine.

At home:

• Rest: Avoid lifting >5kg, driving, or exercise for 4–6 weeks.
• Pain relief: Use prescribed medications or over-the-counter options (e.g., paracetamol).
• Wound care: Keep incisions clean/dry; watch for redness/swelling.
• Activity:
  • Gentle walks aid recovery; gradually resume daily tasks.
  • Avoid sex, tampons, or baths for 6 weeks.

Return to work: Typically, 4–6 weeks (adjust based on job demands).

Long-Term Effects

• Menopause: Occurs immediately if ovaries are removed (hormone replacement therapy may be offered).
• No periods: Permanent end to menstrual bleeding.
• Body changes: Scarring is minimal; some report temporary bladder/bowel adjustments.

Frequently Asked Questions

Q: Will I have visible scars?
A: Incisions heal into small, faint marks (less noticeable than open surgery).

Q: How soon can I resume sexual activity?
A: Wait 6–8 weeks to allow internal healing.

Q: Can the robot malfunction during surgery?
A: Rare – surgeons are trained to manage technical issues, and safety protocols are in place.

Q: Will I gain weight after surgery?
A: No direct link, but lifestyle changes during recovery may affect weight.

eGynaecologist Advice:

• You should seek gynaecological help if you have severe pain, fever, or chills after hysterectomy procedure or notice heavy bleeding or foul-smelling discharge from incisions
• You must seek urgent gynaecological review if you develop chest pain, shortness of breath, or calf swelling after while you are recovering from surgical procedure
• Hysterectomy procedurestops menstrual periods permanently and if ovaries are removed, menopause begins immediately. You should consult your gynaecologist if you need hormone replacement after hysterectomy