Robotic-assisted myomectomy is a technique used to perform a laparoscopic myomectomy that uses robotic arms controlled by the surgeon. The procedure is performed to remove uterine fibroids that are causing heavy bleeding or other symptoms.
Uterine fibroids are growths that are made up of the same type of cells that the uterine lining is made from but they are abnormally reproducing and growing in the form of fibroids in locations that they are not supposed to be in.
Fibroids are almost always noncancerous and can be small like a pearl or grow up to the size of a big pumpkin. They can grow in various places within the uterine area and even be growing into the uterine wall.
How Does A Robotic Myomectomy Differ From A Regular Myomectomy?
Traditional open myomectomy requires a large incision to allow a surgeon’s hands access to remove fibroids. Laparoscopic myomectomy is less invasive and requires a few small incisions in the abdomen to allow a small camera and other surgical instruments inside the abdominal cavity where the surgeon manually removes the fibroids.
The procedure for the myomectomy is performed pretty much the same using laparoscopy, however, instead of the surgeon holding the medical instruments in their hands, the instruments are held by robotic arms.
Using robotic technology has the advantage of being extremely precise while mimicking the movements of the surgeon’s hands with the added ability to maneuver in ways that the human hand would not be able to move. Robotic-assisted myomectomy allows the surgeon a panoramic view of the area that is being operated on and eliminates much of the fatigue a surgeon would endure if manually performing a surgery.
What Is The Procedure For Robotic Myomectomy?
Both a laparoscopic myomectomy and a robotic-assisted laparoscopic myomectomy are done while the patient is asleep under general anesthesia.
During a laparoscopic myomectomy, about four small incisions are made into the abdominal area and the surgical instruments are inserted. One instrument has a tiny camera attached and allows the surgeon a 2-dimensional view of the surgical site and another is an instrument that is used to remove the fibroid.
Robotic-assisted technology is carried out in the same manner but the view from the tiny camera is 3-dimensional and allows for greater detail. The surgeon uses the camera to locate the fibroids and with precision and control the robotic arms replicate the surgeon’s movements.
The fibroids are extracted one at a time by cutting them into small pieces and removing them through one of the small incisions. This process is repeated until the fibroids that can be located and accessed are removed and then often, the surgeon has to stitch the uterus back together.
Next, the instruments are removed and the incision sites on the abdomen are stitched back together and bandaged.
Normally women spend a night or two in the hospital after the surgery and are then discharged with instructions on caring for their incision sites and other post-surgery aftercare directions. The length of recovery for each patient will vary by the intensity of the surgery. For some women who may have had just a few small fibroids removed, the surgery may only have lasted 15 or 20 minutes; however, others may have been in surgery for a few hours. Typical recovery for a robotic-assisted myomectomy is at least 4 weeks.
What Are The Advantages of Robotic-Assisted Myomectomy vs Open Myomectomy?
- Less invasive;
- Less risk of infection and complications;
- Not as painful during recovery;
- Reduced scarring;
- Shorter hospital stay.
What Are The Advantages of Robotic Myomectomy vs Laparoscopic Myomectomy?
- The surgeon’s ability to view the surgical site in 3D and highly detailed;
- Allows for precision and maneuvers that surpass a human manual ability;
- The surgeon does not get as fatigued during the surgical procedure.
What Are The Downsides of Robotic Myomectomy?
- Surgery may take longer;
- The results of surgery are identical to surgery without robotic assistance but cost more;
- Is not recommended for larger fibroids;
- Is not recommended for numerous fibroids.
What Are The Risks Of Robotic-Assisted Myomectomy?
Robotic myomectomy is considered a major surgery due to the use of general anesthesia, however, It is less invasive and requires smaller incisions than a traditional open myomectomy. Any surgical procedure includes risks or potential complications. Some of the risks associated with a myomectomy include:
- Losing too much blood;
- Side effects or complications from general anesthesia;
- Mistaking a cancerous tumor for a fibroid and causing it to spread;
- Nearby organ damage;
- Bladder or bowel damage;
- Failure of equipment.
Is Robotic-Assisted Surgery Better Than Traditional Surgery?
When robotic surgery was introduced and approved by the FDA in 2000, many medical professionals thought that it would be a huge advancement and would change things as significantly as the introduction of laparoscopic surgery. To date, that has not materialized across the board but any significant differences reported varied by type of surgery.
In the case of gynecological surgery, there were no significant differences in results reported. Some surgeons stated that having all their senses involved, including the ‘hands-on’ touch was beneficial to them. The higher cost associated with robotic-assisted surgery is quite significant and depending on the area needing surgery, the results may or may not be worth the extra cost.
Robotic-Assisted Myomectomy vs Uterine Fibroid Embolization
Uterine Fibroid Embolization (UFE) is a procedure that is non-surgical and has a 90% rate of success in significantly reducing or eliminating painful symptoms caused by fibroids. It is performed as an outpatient surgery using local anesthesia, takes around 45 minutes, and does not require a hospital stay.
One of the greatest benefits of UFE is it can treat any type of fibroid, no matter what the size or location and treats them all in the same session. UFE preserves the integrity of the uterus and the average recovery time is just one week.
Dr. John Lipman and Dr. Mitch Ermentrout, interventional radiologists at the Atlanta Fibroid Center, are experts in UFE with over 35 years of experience and have performed over 11,000 procedures.
If you suffer from heavy bleeding or other fibroid-related symptoms, contact The Atlanta Fibroid Center to schedule a consultation. You deserve to live your best life, which does not include pain and symptoms caused by fibroids.