Hysterectomy and Robotic Gynecologic Surgery: Indications and Benefits

Hysterectomy, the surgical removal of the uterus, is one of the most common gynecological procedures worldwide. Robotic-assisted surgery has emerged as an advanced minimally invasive approach, offering significant advantages over traditional methods.

Advantages of Robotic Hysterectomy

Enhanced precision and flexibility: Robotic technology provides surgeons with high-definition 3D visualization and instruments with a wide range of motion, allowing for greater precision in movements.
Reduced postoperative pain and faster recovery: The small incisions and minimal invasiveness lead to less pain and quicker return to daily activities.
Lower risk of complications: Robotic surgery is associated with lower rates of bleeding and infections compared to open surgery.

Indications for Robotic Hysterectomy

Robotic hysterectomy is particularly indicated in the following cases:

Benign conditions: Fibroids, endometriosis, adenomyosis, and refractory uterine bleeding.
Endometrial cancer: The robotic approach is especially beneficial in patients with obesity (BMI ≥35), offering reduced risk of complications and lower conversion rates to open surgery .
Staging in ovarian cancer: Robotic surgery can be utilized for staging in selected cases of early-stage ovarian cancer, providing precision and minimal invasiveness .
Cervical cancer: The efficacy of robotic surgery in early-stage cervical cancer is currently being evaluated through the RACC trial and is not yet established as a standard method .

Guidelines and Recent Studies

According to ESGO guidelines:

Robotic hysterectomy is safe and effective for the treatment of endometrial cancer, particularly in patients with obesity .
The use of robotic surgery for staging in early-stage ovarian cancer is acceptable in selected cases, emphasizing surgeon experience and appropriate patient selection .
The efficacy of robotic surgery in early-stage cervical cancer is currently being evaluated through the RACC trial and is not yet established as a standard method .