Robotic hysterectomy is an advanced minimally invasive surgical method that can be performed through small incisions, offering high-quality visualization and precise surgical control for certain gynecological conditions requiring removal of the uterus. Robotic surgery does not mean that a robot performs the operation independently; the procedure is controlled entirely by the surgeon. In Obstetrician and Gynecologist Prof. Dr. İsmail Mete İtil’s approach, the aim is to assess the underlying condition, uterine anatomy, the patient’s age and fertility expectations, accompanying health conditions, and safe surgical boundaries together to develop a personalized hysterectomy plan.

What Is Robotic Hysterectomy?

Robotic hysterectomy is the removal of the uterus using robot-assisted laparoscopic surgery. The surgeon controls the robotic arms from a console, while the camera system provides a magnified, three-dimensional view of the surgical area.

Compared with conventional open surgery, this procedure can be performed through smaller incisions. However, robotic surgery may not be the most appropriate option for every patient. The decision should be based on physical examination and imaging findings.

For Which Conditions Is Hysterectomy Performed?

A hysterectomy is planned when removal of the uterus is medically necessary. It may be considered for benign conditions, bleeding disorders, or certain precancerous conditions.

Robotic hysterectomy may be performed in the following situations:

Bleeding or pressure symptoms caused by fibroids
Adenomyosis and severe menstrual pain
Abnormal uterine bleeding that does not respond to treatment
Certain conditions associated with uterine prolapse
High-risk conditions such as endometrial hyperplasia
Suspected uterine or cervical cancer
Selected patients with adhesions caused by previous surgeries

How Is Robotic Uterus Removal Surgery Performed?

The operation is performed under general anesthesia. Several small incisions are made in the abdomen. A camera and robotic surgical instruments are inserted through these incisions. The surgeon controls the robotic system to carefully separate the uterus from the surrounding tissues.

Depending on the patient’s condition, the uterus may be removed through the vagina or using another appropriate surgical technique. Whether the ovaries and cervix will be removed and whether any additional procedures are required should be planned before surgery.

Who Is Suitable for Robotic Hysterectomy?

Robotic hysterectomy may be considered for patients who require removal of the uterus, are suitable for minimally invasive surgery, and are medically fit for the procedure. It may offer advantages in certain situations involving a narrow pelvis, adhesions, large fibroids, endometriosis, or the need for precise dissection.

However, alternative surgical methods may be required in patients with severe heart or lung disease, certain advanced-stage cancers, extremely large masses, or conditions that prevent minimally invasive surgery.

Is Robotic Hysterectomy Different From Open Surgery?

Yes. Open surgery requires a larger abdominal incision, whereas robotic hysterectomy is performed through several small incisions. For some patients, this may result in less scarring, reduced tissue trauma, a shorter hospital stay, and a faster return to daily activities.

However, robotic surgery does not always mean that the operation is “easier” or “risk-free.” Surgical safety depends on the patient’s condition, the experience of the surgical team, and the selection of the appropriate surgical method.

How Should Patients Prepare for Robotic Hysterectomy?

Before surgery, a detailed gynecological examination, ultrasound, blood tests, and an anesthesia assessment are performed. When necessary, a smear test, HPV test, biopsy, or advanced imaging may also be requested.

Patients should inform their doctor about all medications they use, especially blood thinners, as well as previous surgeries, childbirth history, allergies, and chronic medical conditions. The aim is not to rush the operation but to establish a safe surgical plan.

What Is the Recovery Process After Robotic Hysterectomy?

Recovery after robotic hysterectomy varies from person to person. Mild pain, abdominal bloating caused by gas, shoulder pain, vaginal spotting, and fatigue may occur during the first few days. Patients are generally encouraged to start walking soon after surgery.

Patients should consider the following during recovery:

Heavy lifting should be avoided
Prescribed medications should be taken regularly
The amount of vaginal bleeding should be monitored
Sexual intercourse should be avoided until approved by the doctor
Fever, foul-smelling discharge, or severe pain should not be ignored
Follow-up appointments should not be missed
Returning to work and exercise should be planned individually

Are the Ovaries Also Removed When the Uterus Is Removed?

A hysterectomy refers to the removal of the uterus; removal of the ovaries is not always necessary. Whether the ovaries should be preserved depends on the patient’s age, menopausal status, family history of cancer, ovarian conditions, and the reason for surgery.

Unnecessary removal of the ovaries in premenopausal patients may have hormonal consequences. Therefore, the decision should be based on an individualized assessment of the potential risks and benefits.

Does Robotic Hysterectomy Affect Sexual Life?

After a hysterectomy, the tissues need time to heal before sexual activity can be resumed. Sexual intercourse is not recommended during the early recovery period. Patients may return to sexual activity after an appropriate period and following their doctor’s examination and approval.

Sexual well-being is not determined solely by the removal of the uterus. Menopausal status, vaginal dryness, pain, pelvic floor muscles, psychological factors, and the relationship between partners should also be considered.

Conclusion

Robotic hysterectomy is an advanced gynecological surgical method that requires the combined assessment of technology, surgical experience, and appropriate patient selection. Prof. Dr. İsmail Mete İtil evaluates the underlying uterine condition, the patient’s age, menopausal status, the possibility of preserving the ovaries, surgical risks, and recovery expectations as a whole.

The aim is to avoid unnecessary surgery, plan safe robotic surgery for suitable patients, and provide a clear roadmap from the preoperative period through recovery. Schedule an appointment for an evaluation and do not delay the treatment you may need.

This article is intended for informational purposes only and does not constitute medical diagnosis or treatment.

Obstetrician and Gynecologist | İsmail Mete İtil

Robotic Hysterectomy