Robotic Myomectomy for Treating Uterine Fibroids
What is Robotic Myomectomy Surgery for Fibroids?
Robotic Myomectomy for uterine fibroids is a minimally invasive procedure that uses laparoscopic myomectomy through small :"keyhole" incisions and reduces patient's recovery time.
Myomectomy is the only surgical treatment of uterine myomas that preserves fertility. The fibroids are removed surgically from the uterus. This is the best method for women who want to become pregnant.
Symptoms such as pressure and heavy bleeding are eliminated or reduced after the fibroids are removed.
Robotic Surgery for Fibroids Overview
The robot-assisted myomectomy combines the thoroughness of the traditional open myomectomy with a minimally invasive procedure, through tiny 1-2 cm incisions in the uterus, and is effective for large tumors.
During the robotic myomectomy procedure, the surgeon sits at a special console with hand and foot controls that move the robotic arms during the operation. The arms of the robot are extremely nimble and are manipulated by the surgeon using joystick-like controls. The robot also has a camera that gives the surgeon a magnified 3-D view, called telepresence surgery. Very small blood vessels and nerves can be seen clearly and can be spared. The hand movements of the surgeon are duplicated in the patient by the robot, but on a much smaller scale. The robot allows cutting away tissue, cauterizing blood vessels, and suturing, using needles held by pincer like "needle drivers." The robot's wrist can turn nearly 360 degrees, allowing great flexibility. The robot also eliminates any tremor in a surgeon's hands, and for delicate work, "motion scaling" software reduces a surgeon's actual hand movements to much smaller, finer instrument movements. Robot assisted surgery allows the surgeon greater dexterity than traditional laparoscopy. The surgeon performs the surgery - not the robot. The robot cannot make decisions on its own.
Although some women with uterine fibroid tumors have to have a hysterectomy, a robotic laparoscopic myomectomy is providing other women an opportunity to retain their uterus and subsequently, retain their fertility. Laparoscopic myomectomies often take longer than open abdominal myomectomies, and up to 28% are converted during surgery to an open abdominal incision if the myomas are too large and/or there are many myomas.
Robotic Myomectomy Recovery Time
The robotic procedure is performed on an outpatient basis and women can return to work in about a week. Robotic myomectormy recovery time is very minimal because there is no incision or hysterectomy.
Advantages of Robotic Myomectomy for Fibroids
There are many advantages to robotic myomectomy over regular laparoscopic myomectomy
- Quicker recovery time
- Less pain and discomfort
- Less scaring
- Less trauma
- Fewer complications, including less blood loss, a decreased need for blood transfusions, and a reduced risk of infection
- Shorter hospital stays
- Faster recoveries
Risk Factors of Robotic Myomectomy
Risk factors for complications during robot-assisted laparoscopic procedures include: pre-existing heart or lung condition, obesity, diabetes, excessive alcohol intake, and previous abdominal or pelvic surgery. Possible complications include recurrence of fibroids, perforation of the uterus or bowel during surgery, weakened uterine wall, pelvic adhesions that can cause pain or bowel obstruction, infertility and the need for special precautions in pregnancy.
Robotic Myomectomy Systems
- The da Vinci Surgical System, developed by Intuitive Surgical
- The ZEUS System, made by Computer Motion
- The Automated Endoscopic System for Optimal Positioning (AESOP) Robotic System, released by Computer Motion
Other Minimally Invasive Uterine Fibroid Treatments
MR guided Focused Ultrasound Surgery: Non-invasive outpatient treatment to reduce the size of the fibroids.
Uterine artery embolization: The uterine artery is injected with polyvinyl alcohol beads, with a catheter, which block the flow of blood to the fibroids and cause necrosis.
See an overview of all uterine fibroid treatment options.