Minimally Invasive Gynecologic Surgery

Robotic-Assisted Myomectomy

What is robotic-assisted myomectomy?

A robotic-assisted myomectomy is a type of surgery. It's done to remove growths in the uterus called fibroids. The surgery is done with special tools.

The uterus is a reproductive organ in the lower belly (abdomen). A baby grows inside the uterus during pregnancy. Sometimes cells from the inside walls of the uterus grow and form tumors called fibroids (also called leiomyomas or myomas). Fibroids are almost always not cancer (benign). They can be very small or as large as a grapefruit. Fibroids are very common. Your risk of fibroids increases with age until you reach menopause.

Fibroids can grow on the outer part of the uterus, in the wall of the uterus, or stick out into the inside of the uterus. One or more fibroids can grow at the same time in different places in the uterus. Fibroids are usually not cancer. But they can still cause problems. Surgery is then done to remove them.

Robotic-assisted myomectomy is one type of surgery to remove fibroids. It's a minimally invasive method. This means it uses smaller cuts (incisions) than a standard surgery. It’s done while you’re asleep under general anesthesia.

During the surgery, your healthcare provider will put small tools and a tiny camera through small incisions on your lower belly. This gives your provider a better view of the area in your body. Your provider moves the tools using a robotic controller. This lets your provider make very precise movements with the tools. Your provider removes the fibroids from your uterus. The tools are then removed. The incisions are closed and bandaged.

Robotic-assisted myomectomy has some benefits over other methods. It may have a lower risk of complications for some people. It can lead to a shorter hospital stay and a faster recovery time. The surgery may also allow a provider to remove fibroids that are hard to remove with another method.

This surgery may not be available in all areas. Robotic surgery is often more expensive than other methods. It can take longer than other types of surgery to remove fibroids. Your healthcare provider can help you decide which surgery will work best for you.

Why might I need robotic-assisted myomectomy?

You might need a myomectomy if you have fibroids that cause severe symptoms, such as:

Heavy and prolonged bleeding during your period
Pelvic pain
Bloating
Infertility
Pregnancy problems
Urinating often
Constipation

If you have minor symptoms, your healthcare provider may advise other treatments. These may include using hormones or taking pain medicine.

A myomectomy removes only the fibroids. The uterus is left in place. This makes it a better choice for people who want to have children.

What are the risks of robotic-assisted myomectomy?

Every surgery has risks. Risks of robotic-assisted myomectomy include:

Infection
Excess bleeding
Blood clots that can travel to the lungs and cause breathing problems
Injury to nearby organs, such as the bowel or ureters
Wound healing problems
Pelvic infection
Pregnancy complications
Reaction to anesthesia
Regrowth of the fibroids after surgery

Your risks may vary depending on your age, your overall health, and the number of fibroids you need removed. Before the surgery, talk with your provider about all your concerns.

How do I get ready for a robotic-assisted myomectomy?

Talk with your healthcare provider about how to prepare for your surgery.

Tell your provider about all the medicines you take. This includes over-the-counter medicines, such as aspirin and all prescription medicines. It also includes herbs, vitamins, and other supplements. You may need to stop taking some medicines before the surgery, such as blood thinners.
If you smoke, you’ll need to stop before your surgery. Smoking can delay healing. Talk with your provider if you need help to stop smoking.
Follow any directions you are given for not eating or drinking before your surgery.
Tell your provider about any recent changes in your health, such as a fever.

You may need to have tests before your surgery, such as:

Electrocardiogram. This test checks your heart rhythm.
Ultrasound. This test is done to create an image of your pelvis to view your fibroids.
MRI. This test gives more detailed information about your fibroids.
Blood tests. These check for infection and anemia, and look at kidney function.

Your provider might give you more instructions about how to prepare.

What happens during a robotic-assisted myomectomy?

Your healthcare provider can help explain the details of your surgery. An ob-gyn (obstetrician/gynecologist) surgeon and a team of specialized nurses will do your surgery. In general, you can expect:

You will be given general anesthesia. This prevents pain and causes you to sleep through the surgery.
A healthcare provider will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.
You may be given antibiotics before and after the surgery. This is to help prevent infection.
The healthcare provider will make a few small incisions on your belly.
A small tube may be used to send some gas into your belly. This is to help the healthcare provider see the area better during surgery.
The provider will pass tools through the small incisions. These include a tiny camera with a light and several robotic tools.
Your provider will use the robotic controller to move the tools and remove the fibroids.
When the surgery is done, the tools will be removed. The incisions will be closed and bandaged.

What happens after a robotic-assisted myomectomy?

After the surgery, your vital signs will be watched. You may be able to go home that same day. Or you may need to stay overnight in the hospital. When you’re ready to go home, you’ll need to have someone drive you.

You may have some pain after the surgery. You can have pain medicine as needed. You can resume a normal diet as soon as you are able to.

Moving around as soon as possible after surgery can help prevent problems such as blood clots. You may need to do breathing therapy to help expand your lungs after surgery.

You may have shoulder pain for several days. This is caused by the gas sent into your belly during surgery. You may also have some fluid leaking from the incisions. Tell your provider if there is a lot of fluid, if it is bloody, or the incisions are red or warm. Call your provider right away if you have:

Fever
Heavy menstrual bleeding
Severe pain
Trouble breathing
Other severe symptoms

Follow all your healthcare provider’s instructions about wound care and medicines. Limit your movement and sexual activity as advised. You might need to have stitches removed at a follow-up appointment. Make sure to go to all your follow-up appointments.

Your fibroid symptoms may go away completely after surgery. Fibroids can grow back. Talk with your provider if your symptoms return.

Talk with your provider if you get pregnant after having fibroids removed with surgery. A cesarean section delivery may be needed for most women after myomectomy to help prevent complications.

Next steps

Before you agree to the test or procedure, make sure you know:

The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure