What is robotic-assisted myomectomy?
A robotic-assisted myomectomy is a type of surgery. It's done to remove growths in a woman’s uterus called fibroids. The surgery is done with special tools.
The uterus is a reproductive organ in a woman’s 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, within 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 incisions than a standard surgery. It’s done while you’re asleep under general anesthesia.
During the surgery, your doctor will put small tools and a tiny camera through small incisions on your lower belly. This gives your doctor a better view of the area in your body. Your doctor moves the tools using a robotic controller. This lets your provider make very precise movements with the tools. The doctor 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
- Pregnancy problems
- Urinating often
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 option for women who want to have children.
What are the risks of robotic-assisted myomectomy?
Every surgery has risks. Risks of robotic-assisted myomectomy include:
- 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 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.
- Don’t eat or drink after midnight the night 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 (ECG). This checks your heart rhythm.
- Ultrasound. This is done to create an image of your pelvis, to view your fibroids.
- MRI. This 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 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 the following:
- 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 doctor will make a few small incisions on your abdomen.
- A small tube may be used to send some gas into your abdomen. This is to help the doctor see the area better during surgery.
- The doctor will pass tools through the small incisions. These include a tiny camera with a light, and several robotic tools.
- Your doctor 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:
- Heavy menstrual bleeding
- Severe pain
- Trouble breathing
- Other severe symptoms
Follow all of 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 of 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 delivery may be needed for most women after myomectomy to help prevent complications.
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