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Hysterectomy for cancer

Procedure overview

A hysterectomy is surgery to remove the uterus. Depending on the location of the cancer, 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; abdominal, laparoscopic, and vaginal.

An abdominal hysterectomy is done through a large incision in the abdomen. A laparoscopic hysterectomy is done using a thin, tube-like instrument with a light and lens (called a laparoscope), and surgical instruments that are passed through small incisions in the abdomen to remove tissue.

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.[1]

A vaginal hysterectomy is done through small incisions in the upper part of the vagina. The uterus is removed through the vagina.[1] 

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

Judys experience with robotic surgery

HRH Foundation, July 2021

Minimally invasive procedures reach all patients

QEII HSC, April 2021

The way of the future

QEII Foundation, February 2021

Kathleen’s story
Kingston HSC, 2019


Performing advanced robotic surgery for gynecologic cancer
Jewish General Hospital, 2018


Robots in Surgeries for Women
Kari Skelton on Lois Hole Hospital, 2017

Women Deserve da Vinci
Royal Alexandra Hospital Foundation, 2015


Potential Benefits​

Studies conducted on robotic assisted hysterectomy for malignant conditions have reported the following benefits:

  • Compared to patients who had an open procedure, patients who had robot assisted hysterectomy experienced fewer complications[2,4,6] and stayed in the hospital for less time.[4,6]
  • Compared to patients who had a laparoscopic procedure, patients who had a robot assisted hysterectomy had fewer, or similar, complications[3,4,6] and stayed in the hospital for the same, or less, time.[3,4,6]
  • Surgeons may switch to an open procedure when doing a robot assisted procedure with the same likelihood, or possibly less, compared to a laparoscopic surgery.[3,4,5,6]

Additional Patient Resources

Visit the the Canadian Cancer Society for more informational about the disease, diagnosis, treatment options and support available.

Community Groups

Educational Videos

Dr. Susie Lau and her patient discuss the benefits of robot assisted hysterectomy

In a Health Podcast Dr. Shannon Salvador talks about robot assisted assisted surgery and its impact on patients, surgeon training and the future of surgery.

Dr. Walter Gotleib on new technology

Dr. Helen Steed helps bring robotic surgery to Edmonton

Dr. Shannon Salvador describes robot assisted surgery

Dr. Walter Gotleib performs single site robotic surgery

Cancer survivor Barbara describes her diagnosis and treatment of her endometrial cancer with surgeon-driven robotic hysterectomy at Princess Margaret Cancer Centre. 

Risks & Considerations

Evidence suggesting that minimally invasive surgery is not as effective in the surgical treatment of cervical cancer has been recently published.[7]  Other gynecologic cancer sites, as well as patient subgroups have been shown to benefit from robotic assisted surgery.

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] Nevis, I. F., Vali, B., Higgins, C., Dhalla, I., Urbach, D., & Bernardini, M. Q. (2016). Robot-assisted hysterectomy for endometrial and cervical cancers: a systematic review. Journal of Robotic Surgery, 11(1), 1–16. https://doi.org/10.1007/s11701-016-0621-9

[3] Park, D.A., Lee, D.H., Kim, S.W. and Lee, S.H. (2016). Comparative safety and effectiveness of robot-assisted laparoscopic hysterectomy versus conventional laparoscopy and laparotomy for endometrial cancer: A systematic review and meta-analysis. European Journal of Surgical Oncology (EJSO), 42(9), pp.1303–1314

[4] Reza, M., et al. “Meta-Analysis of Observational Studies on the Safety and Effectiveness of Robotic Gynaecological Surgery.” British Journal of Surgery, vol. 97, no. 12, 14 Oct. 2010, pp. 1772–1783, 10.1002/bjs.7269. Accessed 18 Dec. 2020.

[5] 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.

[6] O’Neill, Michelle, et al. “Robot-Assisted Hysterectomy Compared to Open and Laparoscopic Approaches: Systematic Review and Meta-Analysis.” Archives of Gynecology and Obstetrics, vol. 287, no. 5, 5 Jan. 2013, pp. 907–918, 10.1007/s00404-012-2681-z. Accessed 18 Dec. 2020.

[7] Ramirez, PT. “Minimally Invasive versus Abdominal Radical Hysterectomy for Cervical Cancer.” New England Journal of Medicine, vol. 397, no. 20, 15 Nov. 2018, pp. 1894–1904, 10.1056/NEJMoa1806395.