Robot-Assisted Myomectomy Surgery

Myomectomy

Uterine fibroids affect 20% to 40% of women during their childbearing years, making them the most common pelvic tumours in women. Since their FDA approval in 2005, robot-assisted myomectomy procedures have transformed the approach to fibroid removal surgery, offering patients a sophisticated alternative to traditional surgical methods.

This comprehensive guide explores everything patients need to know about robot-assisted myomectomy, from its capability to remove fibroids as large as 15 cm in diameter to the benefits that make it an increasingly preferred choice for fibroid treatment.

Why CARE Group Hospitals is Your Top Choice for Robot-assisted Myomectomy Surgery in Hyderabad

CARE Hospitals is at the forefront of medical innovation. It was one of the first healthcare institutions in Hyderabad to offer advanced robot-assisted myomectomy surgery. 

The surgical team at CARE Hospitals consists of extensively trained and highly experienced surgeons who specialise in robot-assisted procedures across various specialities, including gynaecology. 

CARE Hospitals boasts a multidisciplinary approach that benefits patients with co-morbidities who require comprehensive care before and after robot-assisted myomectomy surgery.

Choosing CARE Hospitals for robot-assisted myomectomy offers several distinct advantages:

• Enhanced Surgical Precision - The robot-assisted arms provide extreme flexibility and manoeuvrability, giving surgeons steadier control without injuring surrounding tissues
• Superior Visualisation - Surgeons benefit from high-definition 3D monitors that offer an unparalleled view of the operating field.
• Data-driven Care - Surgeons can make better judgments with access to information from previous operations
• Faster Recovery - Patients experience shorter hospital stays and quicker returns to normal activities

Cutting-edge Surgical Innovations at CARE Hospitals

The integration of revolutionary robot-assisted systems marks a significant advancement in surgical care at CARE Hospitals. 

What makes robot-assisted myomectomy at CARE Hospitals truly outstanding is the range of specialised instruments available:

• Multifunctional EndoWrist instruments that allow efficient completion with minimal instrument exchanges
• Robotic arms with extreme flexibility - Providing steadier control without injuring surrounding tissues
• High-definition 3D monitors - Offering surgeons enhanced visualisation of the operating field
• Exclusive operation theatre complex specifically for robot-assisted surgeries

The facility is supported by 24-hour imaging and laboratory services and blood bank facilities and follows international infection control practices. This comprehensive infrastructure ensures that women undergoing robot-assisted myomectomy receive world-class care from preparation through recovery.

Conditions for Robot-assisted Myomectomy Surgery

Robot-assisted myomectomy offers a uterine-preserving alternative for females who wish to maintain their fertility.

Robot-assisted myomectomy is primarily indicated for women with:

• Certain types of fibroids - This procedure works effectively for fibroids within the uterine wall (intramural) or those projecting to the outside of the uterus (subserosal)
• Smaller fibroids or limited number - The procedure is best suited for patients with any single myoma smaller than 15 cm and fewer than 15 myomas in total
• Uterine fibroids causing chronic symptoms - When fibroids lead to persistent pain or heavy bleeding, this minimally invasive approach offers relief.

Types of Robot-assisted Myomectomy Surgery Procedures

Surgeons at CARE Hospitals offer several types of robot-assisted myomectomy procedures, each tailored to the patient's specific condition:

• Standard Robot-assisted Myomectomy: This technique uses the da Vinci Surgical System with multiple small incisions. Standard robot-assisted myomectomy works best for subserosal, intramural, and fundal fibroids, with studies showing significantly less blood loss and reduced risk of surgical conversion versus traditional laparoscopy.
• Single-site Robot-assisted Myomectomy: This advanced approach requires only a single 2.5-cm vertical incision within the umbilicus. Surgeons insert a multilumen port that accommodates all necessary instruments through this small opening. 
• Hybrid Robot-assisted Approach: This method combines conventional laparoscopic enucleation followed by robot-assisted reconstruction, which is especially beneficial for:
  • Fibroids larger than 10 cm
  • Deep intramural myomas
  • Highly vascular fibroids
  • Cases requiring enhanced countertraction
• Port Placement Variations: The arrangement of robotic ports follows specific patterns to optimise surgical access:
  • Primary port placement depends on fibroid size, positioned at the umbilicus or 2-5 cm above
  • Secondary ports typically form an inverted "W" pattern with 10 cm spacing between ports
  • Additional auxiliary ports may be placed as needed for complex cases

Know the Procedure

The surgical journey involves careful preparation, precise execution, and proper recovery care to ensure optimal outcomes.

Pre-surgery Preparation

Your doctor will schedule a thorough evaluation, including blood tests, imaging studies, and possibly an MRI scan to locate your fibroids precisely. Before surgery day, follow these key instructions:

• Stop eating and drinking according to your doctor's advice, typically several hours before surgery
• Discuss all medications with your healthcare team, including over-the-counter drugs, vitamins and supplements
• Take a shower or bath before arriving for surgery
• Avoid applying lotions, perfumes, deodorants, or nail polish

Robot-assisted Myomectomy Surgical Procedure

The surgery itself utilises the da Vinci Surgical System under general anaesthesia. Initially, the surgeon makes 3-5 small incisions in your abdomen. The surgeon will insert a multilumen port, through which an 8.5-mm camera and specialised surgical instruments are introduced.

Throughout the procedure, the surgeon:

• Injects dilute vasopressin into the myometrium surrounding the myoma to reduce bleeding
• Makes a hysterotomy (uterine incision) over the fibroid
• Carefully enucleates (removes) the fibroid using robot-assisted instruments
• Performs a multilayer closure using sutures
• Removes the fibroid specimen through the incisions

The surgeon controls the robotic arms from a nearby console, viewing the surgical field through a high-definition 3D display. This arrangement provides exceptional precision and control throughout the procedure.

Post-surgery Recovery

Most patients either go home the same day or stay overnight for observation. Initially, you may experience mild discomfort that gradually improves within 24-48 hours. Some shoulder tightness or neck stiffness typically occurs but resolves within 1-2 days.

Full recovery typically takes 2-4 weeks, substantially quicker than traditional open surgery. Follow-up appointments allow your surgeon to monitor healing progress and address concerns.

Risks and Complications

Although this advanced technique offers many benefits, it carries some adverse effects. These include:

• Infection
• Excessive blood loss
• Blood clots
• Injury to nearby organs like the bowel or ureters
• Wound healing problems
• Pelvic infection
• Reactions to anaesthesia
• Regrowth of fibroids
• Morcellation concerns - The process of breaking down fibroids for removal can (in rare cases) spread undiagnosed cancerous tissue.

Benefits Of Robot-Assisted Myomectomy Surgery

Robot-assisted myomectomy offers remarkable advantages that make it an increasingly preferred option for women with uterine fibroids. Effectively remove fibroids while preserving the uterus, resulting in better patient outcomes and fertility preservation. 

The technology provides surgeons with three-dimensional vision, allowing doctors to access smaller, difficult-to-reach tumours with extraordinary accuracy. The robot-assisted approach allows precise removal of fibroids with minimal damage to surrounding uterine tissue. Women typically experience significantly shorter hospital stays after robot-assisted myomectomy versus traditional abdominal myomectomy. 

Key clinical benefits include:

• Reduced blood loss 
• Fewer blood transfusions
• Lower complication rates 
• Better cosmetic results 

Insurance Assistance for Robot-assisted Myomectomy Surgery

Most medical insurance policies in India now cover this advanced procedure. For patients at CARE Hospitals, staff can assist with: 

• Insurance verification and pre-authorisation procedures
• Handles claim-related documentation
• Making the process virtually hassle-free for patients undergoing robot-assisted myomectomy surgery

Second Opinion for Robot-assisted Myomectomy Surgery

Seeking a second opinion serves as a valuable resource for patients considering robot-assisted myomectomy surgery. This step helps women make informed decisions about their treatment options, especially given the ongoing debates about optimal surgical approaches for uterine fibroids.

For optimal results, consider seeking opinions from surgeons who specialise in gynaecological robot-assisted surgeries. Doctors with advanced training in robot-assisted procedures commonly deliver more tailored treatment plans addressing your specific needs.

Conclusion

Robot-assisted myomectomy is a remarkable advancement in fibroid treatment, offering women a minimally invasive option with excellent outcomes. CARE Hospitals leads this surgical innovation in Hyderabad through state-of-the-art robotic systems and experienced surgical teams.

The procedure delivers clear advantages over traditional methods. Patients experience less pain, shorter hospital stays, and faster recovery times. The precision of robotic systems allows surgeons to remove fibroids while protecting the uterus, making it particularly valuable for women planning future pregnancies. At CARE Hospitals, our experts consistently deliver positive outcomes through careful pre-operative planning and precise surgical execution.