What is Robotic Myomectomy? Purpose, Procedure & Results

Robotic myomectomy is a minimally invasive surgical procedure that removes uterine fibroids while keeping your uterus intact. This advanced technique uses a robotic surgical system controlled by your surgeon to precisely remove fibroids through small incisions in your abdomen.

The procedure combines the benefits of traditional surgery with cutting-edge technology. Your surgeon sits at a console and controls robotic arms that hold tiny surgical instruments. This approach offers better precision than human hands alone while being less invasive than open surgery.

What is robotic myomectomy?

Robotic myomectomy is a type of surgery that removes fibroids from your uterus using robotic assistance. The procedure preserves your uterus, making it an excellent choice if you want to maintain your fertility or simply keep your uterus for personal reasons.

During the surgery, your doctor makes 3-5 small incisions in your abdomen, each about the size of a dime. Robotic arms equipped with surgical instruments are inserted through these tiny openings. Your surgeon controls these robotic arms from a nearby console, viewing your internal organs through a high-definition 3D camera.

The robotic system provides your surgeon with enhanced precision and control. The instruments can rotate 360 degrees and move in ways that human wrists cannot. This technology allows for more accurate removal of fibroids while minimizing damage to surrounding healthy tissue.

Why is robotic myomectomy done?

Robotic myomectomy is performed to treat symptomatic uterine fibroids that are affecting your quality of life. Your doctor might recommend this procedure if you're experiencing heavy menstrual bleeding, pelvic pain, or pressure symptoms that haven't responded to other treatments.

This surgery is particularly beneficial if you want to preserve your fertility. Unlike hysterectomy, which removes the entire uterus, robotic myomectomy only removes the fibroids while leaving your uterus intact. This means you can still conceive and carry a pregnancy after the procedure.

Your doctor might also suggest robotic myomectomy if your fibroids are large, numerous, or located in difficult-to-reach areas. The enhanced precision of robotic surgery makes it possible to remove complex fibroids that might be challenging to treat with other minimally invasive techniques.

Sometimes, fibroids can cause complications during pregnancy, such as pain or preterm labor. If you're planning to become pregnant and have problematic fibroids, your doctor might recommend removing them beforehand to reduce pregnancy risks.

What is the procedure for robotic myomectomy?

The robotic myomectomy procedure typically takes 1-4 hours, depending on the size, number, and location of your fibroids. You'll receive general anesthesia, so you'll be completely asleep during the surgery.

First, your surgeon makes several small incisions in your abdomen. The robotic arms and camera are then inserted through these openings. Your surgeon sits at a control console nearby, using hand and foot controls to operate the robotic instruments with incredible precision.

Here's what happens during the main part of the surgery:

1. Your surgeon locates each fibroid using the high-definition 3D camera
2. The robotic instruments carefully separate the fibroid from surrounding healthy tissue
3. Each fibroid is removed through one of the small incisions
4. The uterine wall is carefully repaired with sutures
5. Your surgeon checks for any bleeding and ensures proper healing

The robotic system's precision allows your surgeon to remove fibroids while preserving as much healthy uterine tissue as possible. This careful approach is especially important if you're hoping to become pregnant in the future.

After removing all fibroids, your surgeon closes the incisions with surgical glue or small bandages. You'll be monitored in the recovery room as you wake up from anesthesia.

How to prepare for your robotic myomectomy?

Preparing for robotic myomectomy involves several steps to ensure the best possible outcome. Your doctor will provide specific instructions tailored to your situation, but here are the general preparations you can expect.

About two weeks before surgery, you might need to stop taking certain medications. Blood thinners, aspirin, and some supplements can increase bleeding risk during surgery. Your doctor will give you a complete list of medications to avoid.

You'll likely need to complete these preparations:

• Blood tests to check your overall health
• Imaging studies like MRI or ultrasound to map your fibroids
• Pre-anesthesia consultation to discuss your medical history
• Arranging for someone to drive you home after surgery
• Stopping eating and drinking after midnight before your surgery

Some doctors prescribe medications called GnRH agonists before surgery to shrink fibroids and reduce bleeding. If your doctor recommends this, you'll typically take these medications for 1-3 months before your procedure.

It's important to arrange for help at home during your recovery. While robotic myomectomy has a faster recovery than open surgery, you'll still need assistance with daily activities for the first few days.

How to read your robotic myomectomy results?

Understanding your robotic myomectomy results involves looking at both the immediate surgical outcome and your long-term symptom relief. Your surgeon will discuss the procedure's success with you shortly after surgery.

Immediate results focus on the technical success of the surgery. Your surgeon will tell you how many fibroids were removed, their sizes, and whether any complications occurred. Most robotic myomectomies are considered successful if all targeted fibroids are removed without significant complications.

You'll also receive a pathology report within a few days. This report confirms that the removed tissue was indeed fibroid tissue and rules out any unexpected findings. In the vast majority of cases, the pathology shows benign fibroid tissue, which is exactly what we expect.

Long-term results are measured by symptom improvement over the following months. Most women experience significant reduction in heavy bleeding within 1-2 menstrual cycles after surgery. Pelvic pain and pressure symptoms typically improve within 4-6 weeks as swelling subsides.

Your doctor will schedule follow-up appointments to monitor your healing and symptom improvement. These visits help ensure you're recovering well and that your symptoms are resolving as expected.

How to optimize your robotic myomectomy recovery?

Optimizing your recovery after robotic myomectomy involves following your surgeon's instructions while listening to your body's signals. Most women recover faster from robotic surgery compared to open procedures, but everyone heals at their own pace.

During the first week, focus on rest and gentle movement. You can walk around your home and perform light activities, but avoid lifting anything heavier than 10 pounds. Many women return to desk work within 1-2 weeks, while those with physically demanding jobs may need 4-6 weeks off.

Here are key recovery steps that can help you heal more comfortably:

• Take prescribed pain medications as directed
• Walk short distances several times daily to prevent blood clots
• Avoid driving until you're off pain medication and can move comfortably
• Eat nutritious foods and stay well-hydrated
• Avoid lifting heavy objects for 4-6 weeks
• Wait for your doctor's clearance before resuming sexual activity

Watch for signs that require immediate medical attention, such as heavy bleeding, severe pain, or signs of infection like fever or unusual discharge. While complications are rare, it's important to stay alert during your recovery period.

Most women feel significantly better within 2-3 weeks, with full recovery typically occurring within 6-8 weeks. Your energy levels and comfort will gradually improve as your body heals from the surgery.

What are the benefits of robotic myomectomy?

Robotic myomectomy offers several advantages over traditional open surgery and even some benefits compared to standard laparoscopic procedures. The most significant benefit is the combination of minimally invasive techniques with enhanced surgical precision.

The smaller incisions mean less pain, reduced scarring, and faster recovery times. Most women go home the same day or after one night in the hospital, compared to 3-4 days for open surgery. You'll also have less risk of infection and blood loss.

The robotic system provides your surgeon with superior visualization and control. The 3D high-definition camera offers a magnified view of your internal organs, while the robotic instruments can move with greater precision than human hands. This technology allows for more thorough fibroid removal while better preserving healthy tissue.

For women hoping to conceive, robotic myomectomy offers excellent fertility preservation. The precise suturing techniques possible with robotic surgery help ensure strong uterine wall healing, which is crucial for supporting future pregnancies.

Many women also appreciate the cosmetic benefits. The small incisions heal to barely visible scars, unlike the larger scar from open surgery. This can be particularly important for your confidence and comfort with your body after surgery.

What are the risk factors for complications with robotic myomectomy?

While robotic myomectomy is generally very safe, certain factors can increase your risk of complications. Understanding these risk factors helps you and your doctor make the best decisions about your treatment.

Your fibroid characteristics play a significant role in determining surgical risk. Large fibroids, multiple fibroids, or fibroids in difficult locations can make surgery more complex and slightly increase complication risks.

Several patient factors can influence your surgical risk:

• Previous abdominal or pelvic surgeries that may have caused scar tissue
• Obesity, which can make surgery more technically challenging
• Bleeding disorders or taking blood-thinning medications
• Heart or lung conditions that increase anesthesia risks
• Previous infections or endometriosis affecting pelvic organs

Your surgeon will carefully evaluate these factors during your consultation. In some cases, additional preparations or alternative treatment approaches might be recommended to minimize risks.

Age alone doesn't significantly increase risks, but older women may have other health conditions that need consideration. Your overall health status is more important than your age in determining surgical safety.

What are the possible complications of robotic myomectomy?

Complications from robotic myomectomy are relatively rare, occurring in less than 5% of procedures. However, it's important to understand what problems can occur so you can recognize them and seek appropriate care if needed.

The most common complications are generally minor and resolve quickly. These include temporary bloating from the gas used during surgery, mild nausea from anesthesia, and some discomfort at the incision sites. Most women experience these minor issues for just a few days.

More serious complications, while uncommon, can include:

• Bleeding requiring blood transfusion (less than 1% of cases)
• Infection at incision sites or within the abdomen
• Injury to nearby organs like the bladder or bowel
• Conversion to open surgery if robotic approach becomes unsafe
• Blood clots in the legs or lungs

Very rarely, complications can affect future fertility. Excessive scar tissue formation or weakening of the uterine wall could potentially impact pregnancy, though this occurs in less than 1% of cases when surgery is performed by experienced surgeons.

Your surgical team takes numerous precautions to prevent complications. These include careful patient selection, thorough preoperative planning, and constant monitoring during surgery. The robotic system's precision also helps minimize the risk of inadvertent tissue damage.

When should I see a doctor after robotic myomectomy?

You should contact your doctor immediately if you experience any concerning symptoms during your recovery. While most healing progresses smoothly, it's crucial to recognize signs that require prompt medical attention.

Call your doctor right away if you develop heavy bleeding that soaks more than one pad per hour, severe abdominal pain that doesn't improve with prescribed pain medication, or signs of infection like fever over 101°F, chills, or unusual discharge with a foul odor.

Other symptoms that warrant immediate medical care include:

• Difficulty breathing or chest pain
• Severe leg swelling or pain, especially in one leg
• Persistent vomiting or inability to keep fluids down
• Severe dizziness or fainting
• Incision sites that become increasingly red, swollen, or painful

You should also contact your doctor for less urgent but still important concerns. These include pain that seems to be getting worse instead of better after the first few days, or any symptoms that worry you even if they seem minor.

Follow-up appointments are typically scheduled at 1-2 weeks and 6-8 weeks after surgery. These visits are important even if you're feeling well, as they allow your doctor to ensure proper healing and address any concerns you might have.