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About da Vinci^® Surgery

Benign Hysterectomy

Learn about hysterectomy surgery for benign conditions and understand your options

You deserve special care

If you have a benign condition of your reproductive system, it may be affecting your health and quality of life. A benign condition is one that is noncancerous. Common benign gynecologic conditions are fibroids (benign tumors), endometriosis, and pelvic support problems.¹ You may be experiencing pelvic pain or pressure, abnormal uterine bleeding, or pain during intercourse.^2-4

Understanding your options

Your doctor may recommend waiting to see if your symptoms progress or may try medical options such as medications to address your symptoms. It is possible your doctor may recommend a hysterectomy, a surgery to remove your uterus and possibly your ovaries and fallopian tubes.

Surgeons can perform a hysterectomy through open surgery, which requires a large incision in your abdomen, or a minimally invasive approach. In traditional open surgery, the surgeon looks directly at the surgical area through a large incision and removes the uterus using hand-held tools.

There are three types of minimally invasive approaches: vaginal hysterectomy, laparoscopic hysterectomy, or robotic-assisted surgery, possibly with da Vinci® technology. Vaginal hysterectomy removes the uterus through an incision in your vagina. Doctors perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision near the belly button. To perform a laparoscopic hysterectomy, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.

How da Vinci works Surgeons using da Vinci technology may be able to remove your uterus through either a few small incisions (cuts) or through one small incision in your belly button using Single-Site® technology. During surgery, your surgeon sits at a console next to you and operates using tiny instruments. A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci system in real time to bend and rotate the instruments with precision.

It’s important to remember that Intuitive does not provide medical advice. After discussing all options with your doctor, only you and your doctor can determine whether surgery with da Vinci is appropriate for your situation. You should always ask your surgeon about his or her training, experience, and patient outcomes.

More about da Vinci

Why surgery with da Vinci?

A review of published studies suggests that potential benefits of a benign hysterectomy with da Vinci technology include:

• Patients may experience fewer complications compared to patients who had open^5-8 and laparoscopic^5,8,10 surgery.
• Patients may stay in the hospital for a shorter amount of time than patients who had open,^5-9 laparoscopic^5,6,8-12 and vaginal^6,8,9 surgery.
• Surgeons may be less likely to switch to an open procedure when performing surgery with da Vinci, compared to when performing laparoscopic surgery.^6,10
• With da Vinci, you may have a single or few small incisions compared to an open procedure and, after surgery, one or a few small scars.

All surgery involves risk. You can read more about associated risks of hysterectomy for benign conditions here.

Questions you can ask your doctor

• What medical and surgical options are available for me?
• Which is best for my situation?
• What are the differences between open, vaginal, laparoscopic, and robotic-assisted surgery?
• If I am a candidate for hysterectomy, how can I prepare for it?
• Can you tell me about your training, experience, and patient outcomes with da Vinci?

Resources for learning more

Hysterectomy surgery brochure Take away information about benign hysterectomy surgery with da Vinci technology in our brochure designed for patients and their families. About your options

Gynecologic surgery with da Vinci  Robotic-assisted surgery with da Vinci technology is used in many different types of procedures by gynecology surgeons. About the specialty

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^{1. Hysterectomy. The American College of Obstetricians and Gynecologists. Web. 21 January 2019.} 

^{2. Uterine Fibroids. The American College of Obstetricians and Gynecologists. Web. 21 January 2019.} 

^{3. Endometriosis. The American College of Obstetricians and Gynecologists. Web. 21 January 2019.} 

^{4. Pelvic Support Problems. The American College of Obstetricians and Gynecologists. Web. 21 January 2019.} 

^{5. Ho C, Tsakonas E, Tran K, Cimon K, Severn M, Mierzwinski-Urban M, Corcos J, Pautler S. “Robot-Assisted Surgery Compared with Open Surgery and Laparoscopic Surgery: Clinical Effectiveness and Economic Analyses.” Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2011 Sep.}

^{6. Landeen, Laurie B., MD, MBA, Maria C. Bell, MD, MPH, Helen B. Hubert, MPH, PhD, Larissa Y. Bennis, MD, Siri S. Knutsten-Larsen, MD, and Usha Seshari-Kreaden, MSc. "Clinical and Cost Comparisons for Hysterectomy via Abdominal, Standard Laparoscopic, Vaginal and Robot-assisted Approaches." South Dakota Medicine 64.6 (2011): 197-209. Print.}

^{7. Geppert B, Lönnerfors C, Persson J. “Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery.” Acta Obstet Gynecol Scand. 90.11 (2011): 1210-1217. doi: 10.1111/j.1600-0412.2011.01253.x. Epub.}

^{8. Lim, Peter C., John T. Crane, Eric J. English, Richard W. Farnam, Devin M. Garza, Marc L. Winter, and Jerry L. Rozeboom. “Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications.” International Journal of Gynecology & Obstetrics 133.3 (2016): 359–364. Print.}

^{9. Martino, Martin A., MD, Elizabeth A. Berger, DO, Jeffrey T. McFetridge, MD, Jocelyn Shubella, BS, Gabrielle Gosciniak, BA, Taylor Wejkszner, BA, Gregory F. Kainz, DO, Jeremy Patriarco, BS, M. B. Thomas, MD, and Richard Boulay, MD. "A Comparison of Quality Outcome Measures in Patients Having a Hysterectomy for Benign Disease: Robotic vs. Non-robotic Approaches." Journal of Minimally Invasive Gynecology 21.3 (2014): 389-93. Web.}

^{10. Scandola, Michele, Lorenzo Grespan, Marco Vicentini, and Paolo Fiorini. "Robot-Assisted Laparoscopic Hysterectomy vs Traditional Laparoscopic Hysterectomy: Five Metaanalyses." Journal of Minimally Invasive Gynecology 18.6 (2011): 705-15. Print.}

^{11. Wright, Jason D., Cande V. Ananth, Sharyn N. Lewin, William M. Burke, Yu-Shiang Lu, Alfred I. Neugut, Thomas J. Herzog, and Dawn L. Hershman. "Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease." Jama 309.7 (2013): 689-98. Print.}

^{12. Orady, Mona, Alexander Hrynewych, A. Karim Nawfal, and Ganesa Wegienka. "Comparison of Robotic-Assisted Hysterectomy to Other Minimally Invasive Approaches." JSLS, Journal of the Society of Laparoendoscopic Surgeons 16.4 (2012): 542-48. Print.}

Disclosures and Important Safety Information

Surgical Risks

Risks associated with hysterectomy, benign (removal of the uterus and possibly nearby organs) include injury to the ureters (the ureters drain urine from the kidney into the bladder), vaginal cuff problems (scar tissue in vaginal incision, infection, bacterial skin infection, pooling/clotting of blood, incision opens or separates), injury to bladder (organ that holds urine), bowel injury, vaginal shortening, problems urinating (cannot empty bladder, urgent or frequent need to urinate, leaking urine, slow or weak stream), vaginal fistula (abnormal hole from the vagina into the urinary tract or rectum), vaginal tear or deep cut. Uterine tissue may contain unsuspected cancer. The cutting or morcellation of uterine tissue during surgery may spread cancer, and decrease the long-term survival of patients.

Important Safety Information

Patients should talk to their doctor to decide if da Vinci® surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options and associated risks in order to make an informed decision. 

Serious complications may occur in any surgery, including da Vinci surgery, up to and including death. Serious risks include, but are not limited to, injury to tissues and organs and conversion to other surgical techniques which could result in a longer operative time and/or increased complications. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.intuitive.com/safety. 

Individuals' outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience.

Da Vinci Xi® System Precaution Statement

The demonstration of safety and effectiveness for the specific procedure(s) discussed in this material was based on evaluation of the device as a surgical tool and did not include evaluation of outcomes related to the treatment of cancer (overall survival, disease-free survival, local recurrence) or treatment of the patient’s underlying disease/condition. Device usage in all surgical procedures should be guided by the clinical judgment of an adequately trained surgeon. 

Medical Advice and Locating a Doctor

Patients should talk to their doctor to decide if da Vinci surgery is right for them. Other options may be available and appropriate. Only a doctor can determine whether da Vinci surgery is appropriate for a patient’s situation. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision.

Surgeons who perform surgery using the da Vinci system can be found using the Surgeon Locator. Intuitive Surgical provides surgeons with training on the use of the da Vinci system but does not certify, credential or qualify the surgeons listed in the Surgeon Locator.

Published Evidence

In order to provide benefit and risk information, Intuitive Surgical reviews the highest available level of evidence on procedures named above. Intuitive Surgical strives to provide a complete, fair and balanced view of the clinical literature. However, our materials should not be seen as a substitute for a comprehensive literature review for inclusion of all potential outcomes. We encourage patients and physicians to review the original publications and all available literature in order to make an informed decision. Clinical studies are typically available at pubmed.gov. 

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