Women's Connection: Robotic Hysterectomy

Rapid Recovery: How RoboticSurgery Benefits WomenMatthew Voth, MD, OB-GynVia Christi Clinic

Hysterectomy  Most common GYN procedure  1/3 of women by age 60  620,000 per year  73% for benign conditions

Reasons for Hysterectomy  Irregular bleeding  Painful periods  Persistent abnormal pap smears  Uterine prolapse  Cancer

Types of Hysterectomy  Total  Partial  Radical

Abdominal Vaginal Laparoscopic TotalAssisted Vaginal Laparoscopic

Which one to choose? VS.

What are we thinking?  Safest route  Shortest recovery  Experience with procedure  Long term outcome  Alternatives

What should YOU be thinking?  Effectiveness  Shortest recovery  Long term outcomes  Alternatives??

Alternatives  IUD  Combined Hormone Therapy  Lysteda  Endometrial Ablation  Uterine Artery Embolization

Abdominal Hysterectomy  Long considered standard  Better visualization  Tactile advantage  EBL 300-500 cc’s  3 day hospitalization  4-6 week recovery

Vaginal Hysterectomy  No abdominal incisions  EBL 200-500 cc’s  1-2 day hospitalization  2-4 week recovery  Proper patient selection

Laparascopic Assisted Vaginal  Faster recovery than abdominal approach  3-4 small incisions  EBL 100-300 cc’s  2-4 week recovery  Easier to get ovaries/adhesions

Total Laparoscopic Hysterectomy  100% completed from above  Cervix can be left (controversial)  Morcellator  EBL 50-500 cc’s  1-4 week recovery

In an ideal world.....  Vaginal hysterectomy

Surgery  Options to consider

da Vinci Robot

Advantages  Can tackle ALMOST everything  Recovery of Laparoscopy, visualization better than open procedure  Maneuverability of instruments  Fast

What to Expect  1 hour surgery  Recover 2 hours, then to room  Catheter out 4-6 hours post-op  No restriction on eating  Home the same day or following morning

What to Expect… continued  Narcotics the first several days  50% of patients, pain med free at 7 days  Back to work in 1-3 weeks

RestrictionsVERY IMPORTANT  No lifting> 20# for 6 weeks  No intercourse for 6 weeks

Random Thoughts  Ovarian preservation  Hormone replacement therapy

Robotic Surgery

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Women's Connection: Robotic Hysterectomy

by Via Christi Health

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