Robotic hysterectomy for benign disease

What is a hysterectomy?

A hysterectomy is an operation to remove either the uterus or both the uterus and the cervix.

If a hysterectomy is required, we will recommend robot-assisted (robotic) surgery. During this keyhole operation, we’ll perform the hysterectomy using four or five 8mm instruments inserted through small abdominal incisions at the level of the umbilicus (belly button).

During the robotic-assisted surgery, we use natural wrist movements to control the instruments, allowing for greater precision, plus better access, flexibility and control of the operation, with a magnified, 3D view of the operating field.

Keyhole robotic hysterectomy is usually quicker, with faster recovery times, and results in less postoperative pain and blood loss than with traditional techniques.

Why might I need a hysterectomy?

There are many reasons why a hysterectomy might be the most suitable treatment options. These include:

  • Endometriosis and adenomyosis in cases where fertility is no longer required 
  • Uterine fibroids in cases where fertility is no longer required
  • Uterine prolapse (often performed together with prolapse plastic surgery)
  • Abnormal vaginal bleeding/heavy menstrual bleeding where other treatments have failed and fertility is no longer required
  • Pelvic pain

What are the potential risks?

Most patients who undergo keyhole robotic-assisted hysterectomy have no serious problems or complications from the surgery. That said, a hysterectomy is major surgery and is not without risk or possible complications. Although uncommon, these can include:

  • Blood clots forming in the legs or lungs (deep vein thrombosis and pulmonary embolism)
  • Chronic pain persistence
  • Infection
  • Injury to surrounding organs, including the bladder, bowel, nerves, and large blood vessels.
  • Severe haemorrhage requiring blood transfusion
  • Urinary incontinence
  • Vaginal fistula formation (an abnormal connection that forms between the vagina and bladder or rectum)
  • Vaginal prolapse 

Our surgical and anaesthetic team take your risk management extremely seriously, and are dedicated to making sure your surgery and recovery are as smooth as possible and complication free.

What happens with a robotic hysterectomy?

During the procedure

Your hysterectomy will be performed under general anaesthetic. Once the anaesthetist has confirmed you are asleep and breathing properly, we make four or five small incisions in your abdomen at the level of the belly button and insert special robotic instruments.

The surgeon uses these instruments to perform the surgery, controlling them from a console in the same room with incredible precision.

During the hysterectomy procedure, the blood supply to the uterus and cervix (as well as the fallopian tubes and ovaries if required) is stopped, and a circular cut is made at the very top of the vagina, where the cervix is connected.

The uterus, cervix (and fallopian tubes and ovaries if necessary) are then removed through this incision, and sent to the histology department for examination. The vagina is closed with a dissolvable suture and every effort made to ensure there is no residual bleeding after surgery.

After the operation

When you wake up in the recovery room, you may still have a urinary catheter in your bladder. This will be removed in the morning after your surgery. You’ll also be given very strong pain killers, typically via a patient-controlled analgesia device (PCA), which allows you to self-administer small doses of pain relief.

Overnight, you will be looked after by the nurses on the ward, and your consultant will see you immediately after the surgery and first thing the following morning.

On the first day post-surgery, we’ll make sure your pain is well managed and gently help you to move around and get out of your bed (with the help of a physiotherapist if needed). 

Your surgeon and specialist nurses will be on hand to monitor your progress, checking that you’re recovering well. When you’re ready to go home, you’ll be given some medications to take with you, including painkillers and gentle laxatives.

In the days and weeks following your operation, you can expect some low-grade vaginal bleeding. Recovery after a robotic-assisted hysterectomy is shorter and less painful than after an open abdominal hysterectomy. Full recovery can take between three and six weeks.

For the majority of women, there's no change in sexual function after a hysterectomy, once full recovery is completed, but you will need to avoid penetrative vaginal sex for six weeks after surgery.

Post recovery

After a hysterectomy, you’ll no longer experience symptoms such as heavy menstrual bleeding or pelvic pain. If your condition was leading to painful intercourse, you’re also likely to notice an improvement following surgery.

If your ovaries were also removed as part of the procedure, surgically induced menopause will occur straight away. This can lead to menopausal symptoms, including vaginal dryness, hot flushes, fatigue, night sweats and irritability. We are here to help and are happy to discuss HRT (hormone replacement therapy) or non-hormonal treatments to manage these symptoms. 

If your ovaries were preserved and you weren’t menopausal before your surgery, they will continue to produce hormones and eggs until you reach natural menopause. This will either occur naturally or possibly slightly earlier than would have been the case without surgery.


Book your consultation

Call +44 20 7118 0298 for an appointment with Mr Tsepov.

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