da Vinci Surgical System for Hysterectomy

What is a hysterectomy?
A hysterectomy is an operation to remove a woman's uterus (womb). In some cases, the ovaries and fallopian tubes also are removed. These organs are located in a woman's lower abdomen (see image at right). The cervix is the lower end of the uterus. The ovaries are organs that produce eggs and hormones. The fallopian tubes carry eggs from the ovaries to the uterus.

There are several types of hysterectomy:

• Complete or total. Removes the cervix as well as the uterus. (This is the most common type of hysterectomy.)
• Partial. Removes the upper part of the uterus and leaves the cervix in place.
• Radical. Removes the uterus, the cervix, the upper part of the vagina, and supporting tissues. (This type is done in some cases of cancer.)

Why do women have hysterectomies?
More hysterectomies are done because of fibroids than any other problem of the uterus. For many women with fibroids, symptoms are minimal and require no treatment. Fibroids often shrink after menopause. In some women, however, fibroids can cause heavy bleeding or pain.

Endometriosis happens when the tissue lining the inside of the uterus grows outside the uterus on the ovaries, fallopian tubes or other pelvic or abdominal organs. When medication and surgery do not cure endometriosis, a hysterectomy often is performed.

When the uterus moves from its usual place down into the vagina (uterine prolapse), urinary problems, pelvic pressure or difficulty with bowel movements can occur. This condition may require a hysterectomy.

Hysterectomy may be part of the treatment for cancer of the uterus, cervix or ovary.

If persistent vaginal bleeding – periods that are heavy, not regular or last for many days each cycle – cannot be relieved with nonsurgical methods, your doctor may recommend a hysterectomy.

How is a hysterectomy performed?
Traditional hysterectomies are done through a 6- to 12-inch incision in the abdomen (abdominal hysterectomy) or through the vagina (vaginal hysterectomy) without any external incision. In laparoscopic hysterectomies, the uterus is removed either vaginally or through small incisions made in the abdomen. Using a miniaturized camera inserted into the abdomen through the small incisions, the surgeon can see the uterus and nearby organs on a standard 2D video monitor.

What is the da Vinci surgical system?
The da Vinci surgical system is an alternative to both traditional open surgery and conventional laparoscopy. The da Vinci system's 3D imaging and robotic technology enable surgeons to perform even the most complex and delicate procedures through very small incisions with precision and control.

A da Vinci hysterectomy combines the advantages of conventional open and minimally invasive hysterectomies. Patients typically experience significantly less pain, less blood loss, less scarring, shorter recovery time, a faster return to normal daily activities and in many cases, better clinical outcomes.

How does the da Vinci surgical system work?
The da Vinci system uses what is called a "robotic platform," but that does not mean a robot is performing the surgery. A skilled surgeon is always in control. He or she directs the "robotic" surgical instruments at all times while watching a 3D image of the surgical area and manipulating the da Vinci's robot arms from a console. Even the smallest or most precise movements of the hand controls on the console are transmitted to the instruments inside the patient's abdomen in real time.

The da Vinci's EndoWrist instruments move like a human wrist, which allows the surgeon to operate with dexterity and precision. The instruments, which are inserted through dime-sized incisions, translate the movement of the surgeon's hands in small spaces where a human hand would not fit. EndoWrist instruments are available to perform almost any type of surgical task that might be required.

How long does it take to recuperate after da Vinci surgery?
After a da Vinci surgery, patients are able to go home earlier and return to regular activities sooner than patients who have traditional hysterectomies. Most patients are able to resume normal activities in one or two weeks. Because the incisions are so small healing and recovery time are shortened, infection risk lowered, and post-surgery pain minimized.

Is da Vinci surgery safe?
The da Vinci system has been used successfully in tens of thousands of procedures worldwide for more than five years. The highly magnified, three-dimensional view of the surgical area helps the surgeon see the target anatomy better without a large incision.

The robotic instruments that move like a human wrist make it possible to perform more complex repairs. The surgeon seated at the da VInci console is always in full control of the instruments' micro movements and can fully concentrate on the target anatomy. The surgeon's assistant at the patient's side can help with placement of the robotic arms during the procedure.

Is da Vinci surgery right for every woman who needs a hysterectomy?
It is not indicated for everybody. Your doctor will discuss your diagnosis and treatment with you in depth and will explain what procedures best meet your needs.

This material is for educational purposes only and should in no way be taken to be the practice or provision of medical, nursing, or professional healthcare advice or services. The information should not be used in place of a visit, call, consultation, or advice of your physician, nurse, or other health care provider. The information obtained herein is not exhaustive and does not cover all aspects of the specific disease, ailment, physical condition, or their treatments. Should you have any health care related questions, please call or see your physician, nurse or other health care provider promptly.

Sources: U.S. Department of Health and Human Services, www.4woman.gov; da Vinci Surgical System,

7/2008