Guide to The Role Of Robotic Surgery In Myomectomy
Learn how robotic-assisted myomectomy transforms uterine fibroid removal surgery with precision, minimal scarring, faster recovery, and fertility preservation.
Written by Dr. Dhankecha Mayank Dineshbhai
Reviewed by Dr. Shaik Abdul Kalam MD (Physician)
Last updated on 15th Sep, 2025
Introduction
Uterine fibroids are a common health concern for many women, often leading to symptoms like heavy bleeding, pelvic pain, and fertility issues. When medication and less invasive treatments aren't enough, a myomectomy—a surgery to remove fibroids while preserving the uterus—becomes a leading option. But the thought of major surgery can be daunting. This is where the role of robotic surgery transforms the experience. Robotic-assisted myomectomy represents a significant leap forward in minimally invasive gynaecological care, offering the effectiveness of traditional surgery with remarkably better recovery outcomes. This guide will delve into how this advanced technology works, its profound benefits, and what you can expect if you and your doctor decide it's the right path for you.
What is a Myomectomy and Why is it Performed?
A myomectomy is a specialised surgical procedure designed to remove uterine fibroids (also known as leiomyomas) while leaving the uterus intact. This is a crucial distinction from a hysterectomy, which involves the removal of the entire uterus.
Understanding Uterine Fibroids
Uterine fibroids are noncancerous growths that develop in the muscular wall of the uterus. They can vary dramatically in size, number, and location. While some women experience no symptoms, for others, fibroids can cause significant challenges, including:
- Heavy or prolonged menstrual bleeding
- Severe menstrual cramps
- Pelvic pressure or pain
- Frequent urination
- Pain during intercourse
- Abdominal bloating or enlargement
Goals of Myomectomy Surgery
The primary goals of a myomectomy are to:
- Alleviate the debilitating symptoms caused by fibroids.
- Preserve fertility for women who wish to become pregnant in the future.
- Maintain the structural integrity of the uterus.
Consult a Gynaecologist for the best advice
The Evolution of Myomectomy: From Open Surgery to Robotics
The journey of fibroid removal surgery has been one of constant innovation, aiming to improve patient outcomes and reduce surgical trauma.
Traditional Open Myomectomy
This approach involves a large horizontal or vertical incision (laparotomy) across the abdomen to access and remove the fibroids. While effective, it is associated with a longer hospital stay (3-5 days), significant post-operative pain, a larger scar, and a recovery period of 6-8 weeks.
Laparoscopic Myomectomy
A less invasive approach, laparoscopic surgery uses several small incisions through which a camera and long, thin instruments are inserted. This offers benefits over open surgery like less scarring and a faster recovery. However, the technique is highly demanding for the surgeon due to limited instrument movement and a two-dimensional view.
The Advent of Robotic-Assisted Surgery
Robotic surgery, such as with the da Vinci system, emerged to overcome the limitations of standard laparoscopy. It provides surgeons with superior visualisation, precision, and control, making complex procedures like myomectomy for multiple or large fibroids more feasible through tiny incisions.
How Does Robotic Myomectomy Work?
The da Vinci Surgical System: A Surgeon's Partner
It's vital to understand that the robot does not operate on its own. The da Vinci system is a sophisticated robotic platform entirely controlled by your surgeon. From a console in the operating room, the surgeon views a high-definition, 3D magnified image of your anatomy and operates using master controls that translate their hand movements into smaller, more precise movements of tiny instruments inside your body.
Step-by-Step: The Robotic Myomectomy Procedure
- Anaesthesia: You will be placed under general anaesthesia.
- Incisions: The surgeon makes 4-5 small incisions (each about 1 cm) in your abdomen.
- Access: A cannula (a thin tube) is placed into each incision to provide access for the robotic arms.
- Visualisation: A high-resolution 3D endoscope (camera) is inserted, providing a magnified view of the surgical site.
- Operation: The surgeon controls the robotic arms from the console to carefully dissect and remove the fibroids.
- Reconstruction: The surgeon meticulously stitches the uterine wall back together to ensure strength and minimise future pregnancy risks.
- Removal: The fibroids are removed from the abdomen through one of the small incisions, often using a mechanical morcellator contained within a protective bag.
- Completion: The instruments are removed, and the tiny incisions are closed with sutures.
Key Advantages of Choosing Robotic Myomectomy
The role of robotic surgery in myomectomy is defined by a suite of compelling benefits that directly enhance patient care.
Enhanced Precision and Surgical Control
The system filters out hand tremors and allows for movement in a greater range of motion than the human wrist. This is invaluable when suturing the uterus back together after fibroid removal, a critical step for women wishing to maintain fertility.
Significantly Reduced Recovery Time
Compared to open surgery, patients experience a dramatically faster return to normal life. Hospital stays are often just one night, and many women return to light activities within two weeks, a fraction of the 6-8 weeks required for open surgery recovery.
Minimal Scarring and Improved Cosmesis
The procedure requires only a few small incisions, leading to barely noticeable scars rather than one large abdominal scar.
Lower Blood Loss and Transfusion Rates
The enhanced precision and the use of cautery lead to significantly less blood loss during surgery, reducing the potential need for a blood transfusion.
Are You a Candidate for Robotic Fibroid Surgery?
Ideal Candidate Profile
While many women with symptomatic fibroids are potential candidates, those with the following may benefit most:
- Multiple fibroids.
- Large fibroids (often >10 cm).
- Fibroids located in challenging positions (e.g., near blood vessels, cervix, or ligaments).
- A strong desire to preserve fertility.
Factors Your Doctor Will Consider
A gynaecological surgeon will determine the best approach for you based on the number, size, and location of your fibroids, your overall health, your surgical history (e.g., prior abdominal surgeries), and your personal goals. Consulting a doctor online with Apollo24|7 can be a great first step to discuss your symptoms and get a referral to a specialist who performs robotic procedures.
Potential Risks and Considerations
As with any major surgery, myomectomy carries risks such as infection, bleeding, and damage to surrounding organs. The risk of blood loss, however, is lower with the robotic approach. A specific risk of myomectomy is the potential for recurrence of new fibroids. There is also a small chance that a planned myomectomy may need to be converted to an open procedure or, in rare cases, a hysterectomy if unexpected complications arise.
Recovery and What to Expect After Surgery
The First 24-48 Hours
You will be in the hospital for observation. You can expect some pain and discomfort, managed effectively with medication. You will be encouraged to walk short distances to aid recovery.
The First Few Weeks at Home
- Week 1-2: Focus on rest. Avoid heavy lifting (nothing over 10-15 lbs), bending, and strenuous activity.
- Week 3-4: You can gradually increase activities. Most women return to desk jobs within 2-3 weeks.
- Full recovery to all activities, including intense exercise, typically takes 4-6 weeks.
Long-Term Outlook and Fertility
Periods typically normalise, with a reduction in heavy bleeding and pain. For fertility, it is generally recommended to wait 3-6 months before trying to conceive to allow the uterus to heal completely. The success of a robotic myomectomy for fertility is high, with many women going on to have successful pregnancies.
Cost and Insurance Coverage for Robotic Surgery
Robotic surgery can be more expensive than laparoscopic or open surgery due to the cost of the sophisticated equipment and disposable instruments. However, most major health insurance plans, including Medicare, cover robotic-assisted myomectomy if it is deemed medically necessary. It is crucial to check with your specific insurance provider to understand your coverage, co-pays, and deductibles.
Conclusion
The role of robotic surgery in myomectomy is undeniably transformative. It has successfully bridged the gap between the radical invasiveness of open surgery and the technical limitations of standard laparoscopy. By offering unparalleled precision, minimised recovery times, and excellent outcomes for uterine preservation and fertility, robotic-assisted myomectomy empowers women to treat their fibroids effectively without putting their lives on hold for months. If you are struggling with symptoms of uterine fibroids and considering your surgical options, this advanced technique is certainly worth discussing with a qualified gynaecologic surgeon. It represents a powerful tool in modern women's healthcare, turning a major operation into a manageable procedure with a swift return to health and normalcy.
Consult a Gynaecologist for the best advice
Consult a Gynaecologist for the best advice
Dr. Sanjan Das
Obstetrician and Gynaecologist
15 Years • MBBS,MS
Bengaluru
Apollo Clinic, Sarjapur Road, Bengaluru
Dr. Parul Sharma
Obstetrician and Gynaecologist
8 Years • MBBS, MS (Obstetrics & Gynaecology)
New Delhi
THE DOCTORS NESST, New Delhi
Dr. Asha Rani Singh
Obstetrician and Gynaecologist
24 Years • MBBS DGO
Delhi
Dr Asha Rani Singh Clinic, Delhi
Dr. Mehnaz Rashid
Obstetrician and Gynaecologist
7 Years • MBBS, DNB (Obstetrics & Gynaecology), D.MAS, F.MAS, WALS
Bengaluru
Wellstar Polyclinic and Diagnostic Center, Bengaluru
(225+ Patients)
Dr. Rituparna De
Obstetrician and Gynaecologist
6 Years • MBBS, MS (Obstetrics & Gynaecology)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
Consult a Gynaecologist for the best advice
Dr. Sanjan Das
Obstetrician and Gynaecologist
15 Years • MBBS,MS
Bengaluru
Apollo Clinic, Sarjapur Road, Bengaluru
Dr. Parul Sharma
Obstetrician and Gynaecologist
8 Years • MBBS, MS (Obstetrics & Gynaecology)
New Delhi
THE DOCTORS NESST, New Delhi
Dr. Asha Rani Singh
Obstetrician and Gynaecologist
24 Years • MBBS DGO
Delhi
Dr Asha Rani Singh Clinic, Delhi
Dr. Mehnaz Rashid
Obstetrician and Gynaecologist
7 Years • MBBS, DNB (Obstetrics & Gynaecology), D.MAS, F.MAS, WALS
Bengaluru
Wellstar Polyclinic and Diagnostic Center, Bengaluru
(225+ Patients)
Dr. Rituparna De
Obstetrician and Gynaecologist
6 Years • MBBS, MS (Obstetrics & Gynaecology)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
Frequently Asked Questions
What is the success rate of a robotic myomectomy?
Robotic myomectomy has a very high success rate in alleviating fibroid symptoms like heavy bleeding and pain. Studies show symptom improvement in over 90% of patients, and fertility outcomes are excellent, with pregnancy rates after the procedure being comparable to or better than other surgical methods.
How long does the robotic myomectomy procedure itself take?
The surgery time can vary depending on the number, size, and location of the fibroids. Typically, a robotic myomectomy takes between 2 to 4 hours. While this may be longer than an open surgery, the trade-off is a significantly reduced recovery time.
Are there any activity restrictions after robotic fibroid surgery?
Yes, but they are less severe than with open surgery. You should avoid heavy lifting (anything over 15-20 pounds), strenuous exercise, and swimming for about 4-6 weeks to allow for proper internal healing. You can typically resume driving and desk work within 1-2 weeks.
Can fibroids grow back after a robotic myomectomy?
Yes, there is a possibility of recurrence. A myomectomy removes existing fibroids but does not prevent new ones from forming. The recurrence rate is estimated to be around 10-30% over several years. However, many women never require further treatment.
How do I find a qualified surgeon for a robotic myomectomy?
Look for a board-certified gynaecologist or gynaecologic surgeon who is fellowship-trained in minimally invasive or robotic surgery. Ask about their specific experience: how many robotic myomectomies they perform annually and what their patient outcomes are. You can start your search by booking a physical visit to a doctor with Apollo24|7 who can provide a referral to a specialist.