Our Summary

This research paper looked at how robotic surgery has influenced the practice of minimally invasive hysterectomies (a surgical procedure to remove the uterus) over the past decade. The data used was from a hospital in France between 2010 and 2019, focusing mainly on cases considered to be benign, or non-cancerous. They also looked specifically at surgeons who conducted a high volume of these procedures and more complex cases, including obese patients and those with larger uteruses.

The study found that the use of traditional open surgery (laparotomy) decreased from 62% to 29% during this period, while robotic surgery increased from 26% to 61%. The time spent in the operating room (OR) was less for the more experienced surgeons, and they were able to handle larger uteruses. Also, the amount of blood loss was less in patients with smaller uteruses and those with a lower body mass index (BMI).

In conclusion, the study found that there has been a shift from traditional open surgery to robotic surgery for hysterectomies. It also showed that surgeons who carry out a large number of these procedures can complete them more efficiently and in less time, even when the uterus is larger.

FAQs

  1. How has the practice of minimally invasive hysterectomies changed over the past decade?
  2. What benefits have been observed with the increased use of robotic surgery for hysterectomies?
  3. Does the experience of the surgeon impact the outcome or efficiency of a robotic hysterectomy procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hysterectomy is to discuss all available surgical options, including robotic surgery, with your healthcare provider. Robotic surgery may offer benefits such as shorter recovery time, less pain, and a lower risk of complications compared to traditional open surgery. Additionally, choosing a surgeon who has experience with robotic hysterectomies and performs a high volume of these procedures can lead to better outcomes. It’s important to have a thorough discussion with your doctor to determine the best approach for your individual situation.

Suitable For

Patients who are typically recommended for a hysterectomy include those with:

  • Severe or persistent uterine fibroids that cause symptoms such as heavy menstrual bleeding, pelvic pressure or pain
  • Endometriosis that does not respond to other treatments
  • Uterine prolapse, where the uterus slips into the vagina
  • Abnormal uterine bleeding that does not respond to other treatments
  • Chronic pelvic pain that does not improve with other treatments
  • Gynecologic cancer, such as uterine, cervical or ovarian cancer

It is important for patients to discuss their individual medical history and symptoms with their healthcare provider to determine if a hysterectomy is the best treatment option for them.

Timeline

Before hysterectomy:

  • Patient will have consultations with their gynecologist to discuss the reasons for the surgery and what to expect
  • Pre-operative tests such as blood work, imaging tests, and possibly a pelvic exam will be performed
  • Patient will be given instructions on how to prepare for the surgery, including fasting before the procedure
  • Surgery will be scheduled and the patient will be advised on what to bring to the hospital
  • Patient will undergo the hysterectomy procedure, which can be done through traditional open surgery, laparoscopic surgery, or robotic surgery

After hysterectomy:

  • Patient will stay in the hospital for a few days for monitoring and recovery
  • Pain medication will be provided to manage any discomfort
  • Patient will be given instructions on post-operative care, including how to care for the incision site and when to resume normal activities
  • Follow-up appointments will be scheduled to monitor the healing process and discuss any concerns or complications
  • Patient may experience changes in hormone levels and emotions due to the removal of the uterus, which can be managed with hormone replacement therapy or counseling if needed.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hysterectomy based on this research paper could include:

  1. What are the benefits of robotic surgery for hysterectomy compared to traditional open surgery?
  2. How experienced are you in performing minimally invasive hysterectomies, particularly with robotic surgery?
  3. How does the size of my uterus or my BMI affect the success and outcomes of the surgery?
  4. What is the expected amount of blood loss during the procedure, and how does that differ based on the size of my uterus?
  5. How long can I expect to be in the operating room for the surgery, and how does your experience and expertise impact the duration of the procedure?
  6. Are there any specific risks or complications associated with robotic surgery for hysterectomy that I should be aware of?
  7. How does your hospital or practice determine the best surgical approach for each individual patient, taking into consideration factors such as BMI and uterine size?
  8. What is the recovery process like for minimally invasive hysterectomies, and how does that differ from traditional open surgery?
  9. Are there any specific guidelines or recommendations for post-operative care and follow-up appointments after a robotic hysterectomy?
  10. Can you provide me with any additional information or resources about the use of robotic surgery for hysterectomies, particularly in cases like mine that are considered benign or non-cancerous?

Reference

Authors: Carbonnel M, Moawad GN, Tarazi MM, Revaux A, Kennel T, Favre-Inhofer A, Ayoubi JM. Journal: JSLS. 2021 Jan-Mar;25(1):e2020.00091. doi: 10.4293/JSLS.2020.00091. PMID: 33879990