Overview

Robotic myomectomy is a minimally invasive way for surgeons to remove your uterine fibroids. You and your doctor can discuss your treatment options. Possible advantages of robotic myomectomy are that you'll likely have less pain, lose less blood and return to normal activities more quickly than you might after traditional open surgery.

Why it's done

Your doctor may recommend robotic myomectomy if you have:

  • Smaller, or a limited number of, uterine fibroids. Because the incisions used in robotic myomectomy are so small, this procedure works best with smaller uterine fibroids, which are easier to extract.
  • Uterine fibroids that cause chronic pain or heavy bleeding. Robotic myomectomy may be a safe, effective way to get relief. The procedure won't prevent new fibroids from developing, though, so your doctor will probably recommend follow-up exams to see whether you have developed new fibroids.

Risks

Robotic myomectomy has a low complication rate. Still, risks may include:

  • Excessive blood loss. During robotic myomectomy, surgeons take extra steps to avoid excessive bleeding, including blocking flow from the uterine arteries and injecting medications around fibroids to cause blood vessels to clamp down.
  • Infection. Though the risk is small, the robotic myomectomy procedure presents the risk of infection.

How you prepare

Food and medications

You'll need to fast — stop eating or drinking anything — in the hours before your surgery. Follow your doctor's recommendation on the specific number of hours.

If you're on medications, ask your doctor if you should change your usual medication routine in the days before surgery. Tell your doctor about any over-the-counter medications, vitamins or other dietary supplements that you're taking.

Other preparations

In most cases, robotic myomectomy only requires an overnight stay. Your facility may require that you have someone accompany you on the day of surgery. Make sure you have someone lined up to help with transportation and to be supportive.

What you can expect

Before the procedure

Robotic myomectomies are performed under general anesthesia, which means you're asleep during the surgery. Ask about pain medication and how it will likely be given.

During the procedure

In robotic myomectomy, your surgeon accesses and removes fibroids through several small abdominal incisions. The surgeon controls movement of instruments from a separate console.

Using smaller incisions means you may have less pain, lose less blood and return to normal activities more quickly than with other methods of myomectomy.

After the procedure

After a robotic myomectomy, you may stay in the hospital for one or more nights. Your treatment team will observe your condition while you're in the hospital, control your pain and make sure you're comfortable. You may also get medicine to prevent infection. You can expect some vaginal bleeding for several days after the procedure.

During your recovery, which typically lasts about two to three weeks, you'll need to avoid strenuous exercise and heavy lifting. Your doctor may encourage walking or other light exercise. Your doctor can tell you when it's all right to start driving a car, resuming sexual intercourse and trying to get pregnant.

Results

Outcomes from robotic myomectomy may include:

  • Symptom relief. After robotic myomectomy surgery, most women experience relief of bothersome signs and symptoms, such as excessive menstrual bleeding and pelvic pain and pressure.
  • Fertility improvement. After a robotic myomectomy, wait at least three months before attempting conception to allow the uterus enough healing time.

Robotic myomectomy care at Mayo Clinic

May 17, 2018
References
  1. Ascher-Walsh CJ, et al. Robot-assisted laparascopic myomectomy is an improvement over laparotomy in women with a limited number of myomas. Journal of Minimally Invasive Gynecology. 2010;17:306.
  2. Bedient CE, et al. Comparison of robotic and laparoscopic myomectomy. American Journal of Obstetrics and Gynecology. 2009;201:566e1.
  3. Asmar J, et al. Myomectomy by robotically assisted laparoscopic surgery: Results at Foch Hospital, Paris. Frontiers in Surgery. 2015;2:1.
  4. Lewis EI, et al. Robotic single-site myomectomy: Initial report and technique. Fertility and Sterility. 2015;103:1370.
  5. Parker WH. Laparoscopic myomectomy and other laparoscopic treatments for uterine leiomyomas (fibroids). http://www.uptodate.com/home. Accessed March 3, 2016.