Laparoscopy

Laparoscopy (or “keyhole surgery”) is a minimally invasive surgical procedure that allows your doctor to see the inside of your abdomen and pelvis. A thin camera (laparoscope) along with thin instruments are inserted through small skin incisions. The small incisions allow for faster healing and earlier discharge from hospital.

Robotic surgery

Robotic surgery is similar to laparoscopic surgery except that the surgeon uses a specialized surgical robot to control the laparoscopic instruments.

Entry

To start the procedure, a small skin incision is made to introduce the camera (laparoscope). Usually this is located in the left upper abdomen or umbilicus (belly button).

Gas medium

During a robotic hysterectomy, your abdomen will be inflated with carbon dioxide gas to make enough space to see and operate safely. At the end of the surgery, this gas is removed and any leftover gas will be absorbed by your body.

Additional skin incisions

Additional small skin incisions will be made to attach to the robotic arms. Thin instruments are inserted to perform the surgery. Usually 4-6 small (1 cm or less) incisions are made. The location, number, and size of skin incisions are based on your anatomy and the surgery.

Positioning

During the procedure, the bed is tilted with the head down and legs higher in the air (Trendelenberg position). This position allows for the surgeon to clearly see the uterus and other organs in the pelvis.

Uterine manipulator

A uterine manipulator is a surgical instrument that is inserted through the vagina and into the cervix and uterus in order to move the uterus, fallopian tubes, and ovaries during your surgery. This instrument is very important for a robotic hysterectomy.

Hysterectomy

Small instruments are used to disconnect the uterus, cervix, fallopian tubes and ovaries from the vagina. Most of the time, they can be removed from the body through the vagina. Sometimes, if the uterus is too large to fit through the vagina, a larger abdominal incision may be needed to remove the uterus. The top of the vagina is closed with a dissolvable stitch.

Cystoscopy

Usually, at the end of the surgery, a thin camera (cystoscope) is used to look inside the bladder and make sure there are no injuries to the bladder or the ureters.

A tour of the robotics operating room

The robotics operating room typically contains the following equipment:

• 1.       The surgical robot.
• 2.       Operating table with leg supports.
• 3.       The console that controls the robot.
• 4.       A vision tower that shows the operating camera footage.