Robotic Myomectomy Procedure
Overview
Robotic myomectomy is a form of minimally invasive surgery that helps remove uterine fibroids with precision. Compared to abdominal myomectomy, this technique often leads to less blood loss, fewer side effects, and quicker recovery.
Types of Myomectomy Procedures:
Procedure | Approach | Invasiveness |
---|---|---|
Abdominal myomectomy | Open | Most invasive |
Laparoscopic myomectomy | Laparoscopic | Less invasive |
Hysteroscopic myomectomy | Hysteroscopic | Minimally invasive |
Robotic-assisted myomectomy | Robotic | Least invasive |
Robotic-assisted methods might sometimes take longer and cost more than standard laparoscopy, but results are otherwise similar. Surgeons use advanced technology to enhance accuracy with this approach.
Because robotic instruments offer greater dexterity and control, surgeons can work around delicate tissues with improved precision—especially useful for fibroids in hard-to-reach locations.
Reasons for the Procedure
Surgeons perform robotic myomectomy to remove specific types of uterine fibroids, especially those within the uterine wall or growing outward. People often choose this method if they have:
- Smaller or Few Fibroids: Small incisions work well for cases with limited fibroids.
- Chronic Pelvic Pain or Heavy Menstrual Bleeding: Fibroids may cause these symptoms, and surgery can reduce them.
- Fertility or Pregnancy Concerns: Treating fibroids can help with infertility or repeated pregnancy problems.
Symptom or Concern | Potential Benefit of Surgery |
---|---|
Pelvic pain | Relief from chronic discomfort |
Heavy bleeding | Less menstrual blood loss |
Infertility | Improved chances for pregnancy |
Fibroid size/number | Removed more easily with robotics |
This procedure is often preferred by those seeking uterine-sparing surgery, especially if they wish to become pregnant in the future. It is most effective for fibroids that do not protrude into the uterine cavity, as these may be better addressed through hysteroscopic techniques.
Possible Complications
Robotic myomectomy is considered safe, but some risks remain. Surgeons take special steps to lower bleeding if excessive blood loss occurs. Infection can also occur, though it is not common. Other possible issues include:
- Blood clots
- Pelvic infection
- Trouble with wound healing
- Damage to nearby organs (rare)
- Anesthesia-related risks
Scar tissue may develop at the incision sites or internally, which can occasionally affect future fertility or require further treatment.
Getting Ready for Surgery
Eating, Drinking, and Medicine
Patients usually need to stop eating and drinking for several hours before robotic myomectomy. The care team will specify when to start fasting. Anyone taking regular medicine, including vitamins and supplements, should inform the team. Sometimes, doctors change your usual medicine plan before surgery, especially when general anesthesia is involved.
Additional Steps to Prepare
- Wear loose, comfortable clothing
- Arrange for a trusted adult to provide transportation
- Discuss pain management options and recovery plans
- Complete any required labs, imaging, or pre-op testing
Patients are often advised to stop smoking before surgery, as this can improve wound healing and reduce the risk of complications. Some people may be given bowel prep instructions to clear the intestines before surgery, depending on fibroid location.
What You Can Expect
Robotic myomectomy takes place under general anesthesia, so the patient will be asleep throughout the surgery. The healthcare provider may discuss which pain medications will be used and how they will be managed before and after the operation.
Patients often have tests such as ultrasound or an electrocardiogram to evaluate health before surgery. A pelvic ultrasound or MRI may be performed shortly before the surgery to help map the exact size, number, and location of fibroids.
What Happens in the Operating Room
The surgeon makes several small incisions in the abdomen to access the uterus. Using a console near the patient, the surgeon controls robotic arms that perform the surgery using high-definition 3D magnification and precise movements. The fibroids are removed carefully, and the uterus is repaired.
- Some fibroids are removed in pieces through a small bag to prevent tissue spread
- The uterus remains intact unless unexpected complications arise
- Incisions are closed with stitches or surgical glue
Depending on the fibroid’s size or depth, the surgeon may use dissolvable sutures to reconstruct the uterine wall. This helps maintain uterine strength, which is important for future pregnancies.
What Recovery Looks Like
Most patients stay in the hospital for one night after surgery. Nurses and doctors monitor comfort, manage pain, and look for any signs of problems. Vaginal bleeding may occur for several days. Recovery typically takes 2 to 4 weeks, and light activity such as walking is encouraged.
Avoid During Recovery
- Heavy lifting
- Strenuous exercise
- Sexual activity (until cleared by provider)
- Driving (until off pain medication and cleared to do so)
Follow-up appointments are usually scheduled 1 to 2 weeks after surgery to check incision healing and assess recovery. Patients are often prescribed medications to prevent infection, manage pain, and reduce the chance of blood clots. It’s normal to feel fatigued for several days, and returning to work depends on the nature of the job. Desk jobs may resume sooner than physically demanding roles.
Findings
Robotic myomectomy often relieves symptoms like heavy periods, pelvic pain, and pressure. Many patients report less post-surgical pain and experience less blood loss compared to open surgery.
Typical Benefits
- Smaller scars and shorter recovery
- Reduced hospital stay
- Lower risk of adhesions
- Faster return to daily routines
Some individuals achieve better fertility outcomes, and doctors suggest waiting 3 to 6 months before planning pregnancy or undergoing a cesarean section. While robotic myomectomy can improve the chance of pregnancy, it may not be suitable for everyone. The decision depends on fibroid type, location, and reproductive goals.