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Benign Hysterectomy

Procedure overview

A hysterectomy is surgery to remove the uterus. Other organs such as the cervix, ovaries, fallopian tubes, lymph nodes and parts of the vagina may also be removed at the same time.[1]

A hysterectomy can be performed using different surgical approaches. An open, or abdominal approach uses a large incision in the abdomen.[1]  Minimally invasive approaches, including laparoscopic and robotic techniques, use multiple smaller incisions.

A laparoscopic hysterectomy is done using a thin, tube-like instrument with a light and lens (called a laparoscope). By passing the laparoscope and surgical tools through small incisions in the abdomen the surgeon is able to view the organs to be removed.  The uterus is commonly removed through the vagina.

hysterectomy-surgery
Figure 1. Open vs Robotic, Port Placement for Hysterectomy Surgery

Robotic surgery is a form of laparoscopy. During robotic surgery the surgeon performs the operation using robotic arms connected to surgical instruments.  While seated at the surgeon console, the surgeon guides instruments into the small incisions described above .[1]

A hysterectomy may be done to treat cancers of the female reproductive organs, stage cancers of the female reproductive organs to find out how far cancer has spread, or to treat non-cancerous conditions of the female reproductive organs that have not responded well to other types of treatment.

Learn more about what robotic assisted surgery is and how surgeons use the technology here.

Delivering Life-Changing Care
Sinai Health, September 2021

Meet the team at Humber River trained in robot assisted surgery
Humber River Hospital Foundation, February 2021


Robotic Hysterectomy with the da Vinci Surgical System: Miren’s Story
Humber River Hospital Foundation, January 2021


Surgical team offers unique treatment 
St. Michaels Hospital Toronto, Jan 2020


Meet Grateful Patient Lenore Rawlings
London Health Sciences Foundation, 2017


Mindy Wiliamson Speaks Out
London Health Sciences Center Inside, 2016


Potential Benefits​

Studies on robot assisted hysterectomy for benign conditions have reported the following results:

  • Fewer complications compared to patients who had open,[2,4] and laparoscopic[2,3,4] surgery.
  • Shorter hospital stay compared to patients who had open,[2,4] laparoscopic,[2,4,5] and vaginal [4] surgery.
  • Less likely to convert to an open procedure when performing surgery with da Vinci, compared to when performing laparoscopic surgery.[3,6]
  • Single or few small incisions compared to an open procedure and, after surgery, one or a few small scars.

Additional Patient Resources

Visit the the Canadian Womens Health Network for more informational about the disease, diagnosis, treatment options and support available.

Educational Videos

Patient and Surgeon Stories

Dr. Jonathan Solnik describes how da Vinci Robot Assisted Surgery will change the lives of patients at Sinai Health 

Roni shares her patient experience after receiving a robot assisted hysterectomy [US Content]

At London Health Sciences Centre (LHSC), Mindy underwent minimally invasive, robotic-assisted surgery . Back home the day after her surgery and walking her dog two days later, Mindy is now pain-free.

Dr. Andrea Simpson of St Michaels Hospital explains the role of robot assisted surgery in medicine today, and how she uses the tool in her practice.

Risks & Considerations

 Not everyone is a candidate for robotic assisted procedures, and other treatment options may be available and appropriate. Only a doctor can determine whether robotic assisted surgery is appropriate for a patient’s situation. Surgery of any form contains risks and it is important to discuss risks with your provider. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision. 

Patients have also developed support areas where they are able to speak with each other about the surgery, their experiences, and any issues that they have faced during their treatment. To learn more check out the additional resources above or visit the community section of this website. 

[1]  https://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/hysterectomy/?region=on

[2] 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.
[3] 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.

[4] 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.

[5] 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.

[6] Cusimano, M., Simpson, A., Dossa, F., Liani, V., Kaur, Y., Acuna, S., Robertson, D., Satkunaratnam, A., Bernardini, M., Ferguson, S. and Baxter, N., 2019. Laparoscopic and Robotic Hysterectomy in Endometrial Cancer Patients with Obesity: A Systematic Review and Meta-Analysis of Conversions and Complications. Journal of Minimally Invasive Gynecology, 26(7), p.S4.