If you have cervical cancer and need a hysterectomy, a robotic-assisted surgery could offer you some advantages over traditional surgery.
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If the cancer is detected early enough, doctors may recommend radical hysterectomy as a treatment option, says gynecologic oncologist Thomas Morrissey, MD. Today, surgeons more frequently suggest robotic-assisted laparoscopic radical hysterectomy as a faster, less invasive, safer option to traditional “open” surgery done through a larger incision.
A word about radical hysterectomy
Radical hysterectomy is a specific surgical treatment for cervical cancer, which affects the lower part of the uterus that connects to the vagina.
A radical hysterectomy, done either with robotic assistance or the traditional way, removes the uterus, cervix, parts of the vagina, surrounding tissues and lymph nodes, and is the best way to attempt to remove all cancer cells.
“Cervical cancer is usually diagnosed early through Pap smears, and often we are able to prevent it,” Dr. Morrissey says. “We can often pick up precancerous changes through this test or pelvic exams. But, once cervical cancer has developed, it can only be cured by surgery or radiation treatment.”
There are two types of cervical cancer – squamous cell carcinomas and adenocarcinomas – and they respond to the same treatments.
According to existing research, the robotic-assisted surgery is just as effective as the traditional surgery.
This method also shortens procedure time and lessens blood loss. Dr. Morrissey says surgeons use robotic assistance during surgery to provide better visualization and greater accuracy.
Extra ‘hands’ in the operating room
Traditionally, a surgeon holds instruments in his or her own hands. But being limited to only two hands, they need an assistant who can hold things and be asked to move things.
“With the robot, the surgeon can control four arms at once,” Dr. Morrissey says.
“The surgeon still controls everything attached to the computer via remote control, but they can use four instruments at one time. Plus, there’s a 3-dimensional camera for them to be able to see better and manipulate instruments precisely.”
During a robotic-assisted hysterectomy, surgeons make three or four half-inch cuts near the navel.
Surgeons, then, use a laparoscope – a device allowing better vision into the abdomen – and other surgical instruments attached to the computer’s robotic arms to perform the intricate surgery necessary to remove the tissues required to cure the cancer.
Robotic surgery not for everyone
Robotic-assisted radical hysterectomy is best performed by experienced physicians with special training in treatment of gynecologic cancer. There’s no weight limitation, Dr. Morrissey says, but there are other factors that could keep you from having this surgery, including:
Other medical problems — The surgery requires general anesthesia, so any medical problems that prevent total sedation, such as certain heart or lung diseases, could take robotic-assisted surgery away as a treatment option.
Tumor size — Any tumor larger than 4 cm to 5 cm in size should not be treated with surgery and instead should be treated and hopefully cured by radiation treatment and chemotherapy.
Recovery from traditional vs. robotic surgery
A robotic-assisted hysterectomy takes between two to four hours, Dr. Morrissey says. The risks are similar to those of the traditional procedure – bleeding, infection and scarring. But there is less blood loss and scarring with the minimally invasive procedure.
Afterwards, patients have only half-inch scars. Recovery time is faster, and patients experience less pain. After an overnight hospital stay, patients return home and usually get back to normal activities the next day, such as walking around, eating, and walking up stairs. They can drive within a week to 10 days, and start exercising within four to six weeks.
Traditional surgeries are far more involved. Patients generally have 8-inch scars, and hospital stays average between three to five days. Recovery time to normal activities is between four to six weeks instead of days.
Whether you are planning a traditional or robotic surgery, remember that the surgeon is always in control of the procedure.
“Some patients want to make sure it’s the doctor operating – not the robot,” Dr. Morrissey says. “Many surgeons have great experience using this equipment, and everything is under their control. The tool just helps the doctor do a better, more efficient, safer job.”