Laparoscopic and Robotic Surgery

Minimally invasive gynaecological surgery involves performing gynaecological surgical procedures using small cuts (about 1cm or less than ½” each) that previously would have needed a large cut across or along the abdomen. Procedures like removing the womb (hysterectomy) and/or ovaries, cysts, endometriosis and dividing adhesions can all be performed through laparoscopic (key-hole) or robotic surgery.

Advantages

• Having smaller cuts in the abdomen means that scarring is much less than conventional open surgery.
• Recovery is much quicker – most patients can go home the same day or after just one night’s stay and return to normal activities can be as soon as two weeks after surgery.
• The magnification and precision associated with laparoscopic surgery can help with fine procedures like reversal of sterilisation or surgery of the Fallopian tubes.
• Laparoscopic (key-hole) surgery causes fewer adhesions and pain in the abdomen and pelvis compared to open surgery.

Robotic Surgery

Robotic-assisted surgery is a more advanced form of key-hole surgery where the precision and surgical access are greatly enhanced. The robotic surgical system has a component that carries the surgical instruments and camera while the surgeon controls them from a separate console while seated. It is very useful for complex procedures or those that need more than one surgical specialty.

What to expect with your laparoscopic procedure

The procedure will be explained to you in clinic and written information will be given. You will then receive a date for pre-operative assessment at the hospital and a date for your procedure. In some cases, you might be given medication to empty your bowels, especially if you have severe endometriosis or adhesions. You will be asked to fast for at least 6-8 hours before your procedure.

On the day of surgery, you will be seen by the surgeon and anaesthetic doctor before your procedure and consent will be completed. You will also have the chance to ask any questions. You will change into hospital gowns and be given compression stockings to wear (these help to prevent blood clots forming in your legs whilst in surgery).

Once you’re in the anaesthetic room, your identity will be checked and you’ll be asked a few questions about your health. Then a small plastic tube (cannula) will be inserted into your hand or arm and you will be given an oxygen mask to breathe into until you drift off to sleep.

After the procedure you will wake up in recovery. Some procedures, like a hysterectomy, necessitate the presence of a catheter to drain your bladder which usually stays for 12-24 hours. You will have a number of very small cuts with the skin closed with either skin glue or absorbable stitches. You might have pain in one of your shoulders – this is normal after a keyhole procedure as it is due to the gas used during operating irritating the nerves of the diaphragm.

Once on the ward, you will be given pain relief and, in some cases, a small injection to prevent blood clots from forming. Your surgeon will see you after the procedure to explain the findings and possibly show you photos of these. After you’re sent home, the general advice is to avoid driving for about two weeks and avoid weight-bearing exercise for about 6 weeks.

You will be given a follow-up appointment, usually 4-6 weeks after the procedure.