Who is a candidate for Robotically assisted Laparoscopic Hysterectomy and Myomectomy?

Hysterectomy and/or Myomectomy should be the last resort treating symptomatic fibroids. Unfortunately, in spite of available conservative measures such as different hormonal agents and uterine fibroid embolization, many patients still need surgical intervention. In US each year hundreds of thousands of women undergo hysterectomies and myomectomies. The majority are performed by laparotomy which is making a several inch incision through the abdominal wall in order to access the uterus with fibroids. Such an incision which cuts through skin, fascia and muscle, requires a several day hospital stay and six to eight week recovery at home. It is also associated with more pain, higher risk of infection, creation of adhesions and scar tissue, weakening of the abdominal wall and hernia formation.

Fortunately, the vast majority of Hysterectomies and Myomectomies can be performed using advanced laparoscopic techniques, including robotically assisted laparoscopic surgery. Laparoscopy eliminates the need for the several inch long abdominal incision, thus significantly reducing the above mentioned unpleasant results and complications. Every patient suffering from symptomatic fibroids is a proper candidate for such a minimally invasive surgery, regardless of the size or number of fibroids. The bigger the uterus and fibroids, the more challenging it is for the common OB/GYN to perform such advanced robotic and/or laparoscopic surgery. Therefore, unfortunately, many patients are advised by their doctors, that they are not a candidate for the minimally invasive surgery. Many patients don’t seek a second opinion and end up undergoing the much more invasive surgery, laparotomy.

A large size and high number of fibroids, large uterus, heavy weight patient, history of prior abdominal surgeries should not exclude a symptomatic patient from undergoing a minimally invasive Hysterectomy or Myomectomy. Such Robotically assisted Laparoscopic surgery requires only four to five quarter of an inch to half an inch incisions, no hospital stay and 2-3 week recovery at home.

Author

Dr. Nathan Mordel, MD Nathan Mordel, MD, is a board-certified gynecological surgeon at Atlanta Minimally Invasive Gynecologic Surgery Center in Atlanta, Georgia. He specializes in advanced robotic, laparoscopic, vaginal pelvic surgery, including for fibroids, endometriosis, heavy and/or painful menstrual periods, pelvic organ prolapse, and urinary incontinence.