Robot-assisted hysterectomy: An option for most women

There aren’t many reasons to have an open hysterectomy with today’s robotic surgery options.

For nearly a decade, Angela Barnhart knew she had a hysterectomy in her future. Like thousands of women, Barnhart had developed extremely large fibroids — benign tumors that develop in the uterus — that would eventually require surgery.  

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Uterine fibroids are the most common non-cancerous tumors in women and are most commonly found during the middle and later reproductive years. While small fibroids don’t cause symptoms in most women, they can grow to cause heavy and painful menstruation, make sexual intercourse painful and cause frequent or urgent urination.

In the past, treatment would have required an invasive and painful open procedure. But with today’s surgical advances, women like Barnhart who were not candidates for traditional laparoscopic or vaginal hysterectomies — due to the size of either their fibroids or the uterus itself — now have a minimally invasive option in robot-assisted hysterectomy.

“We are able to perform more advanced minimally invasive surgery with the robot that, in the past, would have resulted in an open procedure,” says University of Alabama at Birmingham OB/GYN Heather Greer, M.D. “The 540-degree wristed articulation of the robot instruments coupled with the superior magnification of the robotic camera allows us to perform more challenging procedures, specifically in those patients with complex pelvic anatomy such as large fibroids or excessive scar tissue resulting from multiple C-sections or previous abdominal surgery.”

Barnhart knew her fibroids were large — one was big enough it could be seen on the ultrasound when she was pregnant with her son, who is now 9 years old. They didn’t cause any issues with her pregnancy and she lived with them for many years. Earlier this year, however, that all changed.

“We are able to perform more advanced minimally invasive surgery with the robot that, in the past, would have resulted in an open procedure."

“I started feeling a lot of discomfort and had other issues that come along with fibroids,” she says. “Because they were so large they were putting a lot of pressure on my internal organs. I was referred to Dr. Greer by a friend and had my hysterectomy in July. I feel great now.”

Greer says that in addition to fibroids there are other non-cancerous conditions that make women candidates for robotic hysterectomy. These include:

  • Adenomyosis, which occurs when the endometrial tissue that lines the uterus grows beyond the uterine lining into its outer, muscular wall. This can result in painful, heavy menstrual periods. It is more common in women who are over 30, who have had children, and who have had uterine surgery, including C-sections.
  • Dysmenorrhea, or an excessively painful menstrual period, which is more common in women in their teens and 20s but can be experienced by women throughout their childbearing years.

“Every woman should consider a robotic hysterectomy as an option,” Greer says. “Choosing a robotic hysterectomy is an excellent decision for those women with excess scar tissue as well as women with other medical conditions such as obesity and diabetes.” That is because robotic surgery “decreases morbidity and potential postoperative complications,” Greer notes.

Greer says robotic hysterectomy surgery has several benefits when compared to traditional hysterectomy surgery, including:

  • Minimal blood loss
  • Faster recovery time
  • Less pain
  • Smaller incisions with minimal or no scarring
  • Shorter hospital stay
  • Reduced risk of trauma to surrounding tissue
  • Less disruption to other organs and tissues near the site of the surgery

Barnhart says she wishes she had had her robotic hysterectomy years ago.

“I didn’t realize how the fibroids were affecting my day-to-day life,” she says. “I had lived with them for so long I didn’t know how much of my energy was being zapped by them. I am surprised by the amount of energy I have since my surgery. Now that they are gone, I feel amazing.”

For women interested in learning more about robot-assisted hysterectomies, UAB OB/GYN Brian Gleason, M.D., is presenting “Is a Robotic Hysterectomy Right for You?” at noon, Thursday, Oct. 18, 2012, in the next installment of the UABMD Healthful Webinar series sponsored by UAB Medicine. Greer will be joining the webinar for a question-and-answer session immediately following Gleason’s presentation. Those interested in participating can register at www.uabmd.org.

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