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Purpose of Technology: Robotically assisted hysterectomy (RAH) is intended for the minimally invasive removal of the uterus as a treatment for various medical conditions, including benign conditions such as endometriosis, uterine fibroids, and uterine prolapse. It is also used to treat and stage malignant conditions such as cervical and endometrial cancers.

Rationale: Robotic surgical systems were developed to address the limitations of conventional laparoscopic surgery. The advantages of robotic technology over conventional laparoscopic techniques are the 3-dimensional (3D), panoramic, high-resolution view with depth perception, and the surgeon’s ability to directly control a stable visual field with increased magnification.

Controversy: The number of RAH procedures has increased and robotically assisted surgeries are heavily marketed, despite a lack of evidence suggesting any clinical benefit over conventional laparoscopic hysterectomy (LH) or vaginal hysterectomy (VH). In addition, the American Congress of Obstetricians and Gynecologists (ACOG) considers VH a better option than other surgical approaches for certain conditions.

Relevant Questions:

  • How does RAH compare with other surgical techniques in terms of impact on operative and health outcomes?
  • Is RAH safe?
  • Have definitive patient selection criteria been established for RAH?

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