The US Food and Drug Administration approved the Da Vinci robotic surgery system for gynecologic surgery in 2005. It is one of the newest techniques available for the treatment of gynecologic cancer, fibroids, endometriosis, and prolapse.

The Condition: Uterine Disease, Including Cancer, Fibroids, Endometriosis & Prolapse

A wide variety of conditions affect the uterus, or womb. The uterus is a hollow, muscular organ which holds and feeds a fertilized egg. Traditionally, many conditions affecting the uterus are treated with hysterectomy — the surgical removal of the uterus. U.S. doctors perform about 600,000 hysterectomies every year, making it the second most common surgical procedure. Hysterectomy may offer a lifesaving treatment with serious conditions such as cancer or uncontrollable bleeding. In most cases, however, hysterectomy is an elective procedure performed to relieve chronic pain, bleeding or other disabling conditions. These may be caused by fi broids (noncancerous tumors); endometriosis (noncancerous growth of the uterine lining) or prolapse (falling or slipping of the uterus).

The Treatment: Hysterectomy

Hysterectomy can sometimes be performed through the vagina. However, when the uterus is enlarged — for example, from fi broids or cancer — an abdominal hysterectomy is preferable. This requires a 6-12 inch incision. In some cases, doctors also remove the ovaries because they are thought to release hormones contributing to the condition. While hysterectomy is relatively safe, it may not be appropriate or necessary for all individuals or conditions. Alternative treatments that can preserve the uterus and ovaries may be available. Always ask your doctor about all treatment options, as well as their risks and benefits.

The Condition: Uterine Fibroids

A uterine fi broid is a common type of benign (non-cancerous) tumor that develops within the uterine wall. Uterine fi broids occur in up to one third of all women and are the leading reason for hysterectomy (removal of the uterus) in the United States. One in fi ve women older than 35 years has a uterine fi broid. An estimated 600,000 hysterectomies are performed in the United States annually, and at least one third are for fi broids. Uterine fibroids may grow as a single tumor or in clusters. They often increase in size and frequency with age, but then revert in size after menopause. While not all women with fi broids experience symptoms, symptoms may include excessive menstrual bleeding, pelvic pain and infertility.

The Treatment: Myomectomy

A common alternative to hysterectomy is myomectomy — or surgical removal of uterine fi broids. This procedure preserves the uterus, and may be recommended for women who could become pregnant. Myomectomy is often performed through a large abdominal incision. After removing each fi broid, the surgeon carefully repairs the uterus, to minimize potential bleeding, infection and scarring. Proper repair of the uterus is critical to reducing the risk of uterine rupture during pregnancy.