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Chapter-26 Robotic hysterectomy

BOOK TITLE: Minimally Invasive Gynecologic Surgery: Evidence-Based Laparoscopic, Hysteroscopic and Robotic Procedures

Author
1. Ajao Mobolaji O
2. Wang Karen C
ISBN
9781909836099
DOI
10.5005/jp/books/12892_27
Edition
1/e
Publishing Year
2016
Pages
6
Author Affiliations
1. Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
2. Harvard Medical School; Brigham and Women’s Hospital, Boston, Massachusetts, USA
Chapter keywords
orthopedic assistance, transurethral prostatectomy, conventional laparoscopy, contralateral shoulder, electrosurgical devices, malignant conditions, economic analysis, preoperative mapping, skeletonization, cystoscopy, radiological imaging, laparoscopic hysterectomy, robotic endoscope, counterintuitive movement, computer motion

Abstract

This chapter discusses robotic hysterectomy, where features of the robotic platform provide a mechanism to overcome the limitations of conventional laparoscopy, which can facilitate successfully completion of complex laparoscopic procedures. Neurosurgeons were the first to utilize robotic technology for precise stereotactic brain biopsies, followed by preoperative mapping for transurethral prostatectomy in urology and orthopedic assistance in performing hip arthroplasty. Medical and surgical options are discussed with the patient. Once the patient has been determined to be an appropriate candidate for a robotic hysterectomy approach informed consent is obtained. There is a dearth of evidence demonstrating an advantage of the robotic approach compared to conventional laparoscopy for benign hysterectomy and additional randomized control trials are needed for high-quality data evaluating patient based outcomes and cost-effectiveness. Post-operative expectations and instructions are also provided. Indications for robotic hysterectomy as well as the procedural steps would adhere to the normal practice of the surgeon.

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