Robotic or Laparoscopic Myomectomy and Hysterectomy

Robotics improves surgeons' ability to see, move instruments

Robotic technology has expanded the limits of gynecologic surgery by enabling surgeons to better visualize and more precisely perform highly technical laparoscopic procedures than would otherwise be possible. Robotic technology in association with the laparoscope allows surgeons to view anatomical structures - including small blood vessels, nerves and nearby organs - from a magnified, three-dimensional perspective. Robotics significantly enhances depth perception and range of motion, which enables surgeons to safely perform complex operations by remotely manipulating robotic arms while sitting at a console similar to a pilot's cockpit. Robotic technology adds no risks beyond those associated with laparoscopic hysterectomy.

While the use of robotics in the field of gynecology is increasing, it is estimated that only 2 percent of hysterectomies currently performed in the U.S. employ this technology. UCLA is one of only a few centers in Southern California with the technology and surgical expertise to offer robotic laparoscopic myomectomy and hysterectomy as an alternative for women who might otherwise face the increased risk of complications associated with open abdominal hysterectomysurgery.

Laparoscopic or Robotic (da Vinci) myomectomy

Larparoscopic myomectomy removes fibroids by placing a long, thin scope into a tiny incision made in or near the navel. The scope has a bright light and a camera. This allows the doctor to view the uterus and other organs on a monitor during the procedure. Instruments are used to complete the surgery similar to an abdominal myomectomy.

The hospital stay can last from 1-3 days and recovery time is generally 2-4 weeks In some cases, Laparoscopy can be enhanced with a da Vinci myomectomy that offers some potential benefits over open abdominal surgery, including: less blood loss and need for blood transfusion, shorter hospital stay and faster recovery

Robotic technology has expanded the limits of gynecologic surgery by enabling surgeons to better visualize and more precisely perform highly technical laparoscopic procedures than would otherwise be possible.

Laparoscopic Hysterectomy

In laparoscopic hysterectomy, surgeons can view and access the abdomen through a few, small (1 to 2-centimeter) incisions, and subsequently remove the uterus through the vagina. A Laparoscope (a thin, well light, telescope-like instrument) is the medical tool used. In cases in which the uterus is large or in partial hysterectomies, the surgeon can use an endoscopic morcellator to cut the uterus into small pieces and then remove it and other tissues through the small incisions in the abdomen.

The procedure is associated with faster recovery and fewer complications compared to abdominal hysterectomy. Patients with extensive inflammation, infection or abdominal scarring from previous surgeries may not be appropriate candidates for laparoscopic hysterectomy. Laparoscopic hysterectomy usually requires only 1 day or less in the hospital and less than 1 week of recovery time.

Robotic assisted (da Vinci) Hysterectomy:

An expansion of laparoscopic hysterectomy or myomectomies, with the exception that the specialized laparoscopic instruments are connected to robotic arms, which are guided by the surgeon. This allows the surgeon to have enhanced dexterity, precision, and visualization.

While still done through the laparoscope, da Vinci hysterectomy has the added benefit of allowing more complex surgery to be performed avoiding the need for an open or large incision. This enhancement has been shown to reduce recovery, pain and allow quicker return to work when compared to traditional abdominal hysterectomy.