Robotic myomectomy at a glance
- Robotic myomectomy is the robotic-assisted surgical technique that removes uterine fibroids (uterine leiomyomas) that can contribute to pelvic pain, vaginal bleeding or infertility.
- Robotic myomectomy, a form of minimally invasive surgery, provides the most effective, least invasive treatment for uterine fibroids.
- The myomectomy is a uterine-preserving, fertility-preserving alternative to open abdominal hysterectomy, in which the uterus is removed and the woman’s fertility ends.
- Our surgeons use the da Vinci Surgical System to perform robotic myomectomies.
What is robotic myomectomy?
A myomectomy, sometimes known as a fibroidectomy, is a uterine surgical procedure to remove fibroids while leaving the uterus intact. This procedure can be done via a traditional open surgery, through minimally invasive laparoscopic surgery, hysteroscopic surgery or robotic surgery.
Hysteroscopic myomectomies involve a hysteroscope inserted through the cervix. Laparoscopic myomectomy utilizes small incisions through which a small caliber tube with camera, light and operating instruments is inserted, providing a video view of the area while the surgeon removes the fibroids.
At the Reproductive Science Center of New Jersey, we perform robotic myomectomies with the da Vinci Surgical System. This advanced robotic technology allows the specially trained surgeon to perform a minimally invasive, yet precise, reconstruction of the uterine wall, regardless of the size or location of the fibroids. This type of uterine fibroid surgery is done through several small, 1-2cm incisions in the abdomen, followed by insertion of instruments that are controlled via robotic means.
How the procedure works
The surgeon sits at a console with foot and hand controls attached in order to control the robotic arms used in the da Vinci System. The surgeon is the one operating, not the machine. With the help of the robotic arms, the surgeon is able to perform precise, calculated movements not possible by human hands alone.
With a three-dimensional view, the surgeon can see the operating area at all times. When the surgeon’s hands move during surgery, the robot duplicates the same move on the patient, translating the surgeon’s movements to much smaller ones inside the abdominal cavity. With “motion scaling” software, the robot’s arms eliminate any shaking that the surgeon’s hands may have caused and allow the surgeon to execute difficult moves in cramped places not possible through either traditional or laparoscopic surgery.
Benefits of robotic myomectomy
For many patients a robotic myomectomy can provide the most effective, least invasive treatment for uterine fibroids. It often allows a woman to continue fertility during her childbearing years, and the recovery time is faster than a traditional open abdominal surgery. Among the potential benefits of a robotic myomectomy as compared with traditional open abdominal myomectomy are:
- Opportunity for future pregnancy
- Less pain
- Less blood loss
- Less discomfort
- Less scarring
- A shorter hospital stay
- A faster recovery time.
Not all cases of myomectomy are appropriate for robotic surgery, and sometimes women with uterine fibroids should still have an open abdominal surgery and/or hysterectomy.
As with any surgery, these benefits cannot be guaranteed, as surgery is both patient- and procedure-specific. While myomectomy performed using the da Vinci Surgical System is considered safe and effective, this procedure may not be appropriate for every individual.
Risks & side effects of robotic myomectomy
Risk factors for complications during this procedure include, diabetes, pre-existing heart or lung condition, obesity, high alcohol intake and previous abdominal or pelvic surgery. Possible complications include recurrence of fibroids, damage to tissue, weakened uterine wall, painful pelvic adhesions that can cause bowel obstruction, infertility and the need for special precautions in pregnancy.
During the procedure, the following complications may occur:
- A longer time under anesthesia and longer operating time
- Discomfort from the gas used in the procedure
- Temporary pain or nerve injury resulting from the positioning of the patient’s body.