Hysterectomy for Cancer

Learn about hysterectomy surgery for cancer and understand your options

You deserve special care

If you’ve received a diagnosis for a type of gynecologic cancer, you may be surprised to learn that almost 90,000 women in the U.S.¹ learned they had gynecologic cancer in 2015. 

About 90% of women diagnosed with endometrial cancer have abnormal vaginal bleeding, such as a change in their periods or bleeding between periods, or after menopause.² Pain in the pelvis or abdomen can be a sign of both endometrial and ovarian cancer.^2,3 Other symptoms for ovarian cancer include bloating, trouble eating or feeling full quickly, and urinary symptoms such as urgency.³ It is important to know that these symptoms can also occur with some non-cancerous conditions, but it is important to have a doctor look into your symptoms right away.

To confirm a gynecologic cancer diagnosis, your doctor will likely ask you your medical history and conduct a physical exam. They may do imaging tests, such as an ultrasound, computed tomography (CT) scan (a type of x-ray), or magnetic resonance imaging (MRI). They may also take a biopsy of the tissue, conduct some blood tests, and possibly have you do genetic testing.^4,5

If you have recently received a gynecologic cancer diagnosis, you and your doctor can decide on the course of action that makes sense to you based on factors that include the size of the tumor and whether the cancer is likely to have spread, along with other factors like your age, health, and other personal considerations.

Understanding your options Depending on the type of cancer and how far it has advanced, your doctor may recommend chemotherapy, targeted therapy, immunotherapy, radiation therapy, surgery to remove the affected organ(s) and lymph nodes, or a combination of these options.6,7 Your doctor may recommend a hysterectomy to remove the cancer from your body. Depending on the location of your cancer, your uterus, cervix, a portion of the vagina, fallopian tubes, ovaries and surrounding tissue, ligaments and lymph nodes may be removed. Surgeons can perform a hysterectomy through open surgery, which requires a large incision in your abdomen, or using a minimally invasive approach. In traditional open surgery, the surgeon looks directly at the surgical area through the incision and removes the uterus, other tissue, and lymph nodes using hand-held tools. There are two minimally invasive approaches: laparoscopic hysterectomy and robotic-assisted surgery, possibly with da Vinci® technology. Surgeons perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions. In laparoscopic surgery, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.

How da Vinci works Surgeons can perform hysterectomies for cancer using da Vinci technology. With da Vinci, your surgeon sits at a console next to you and operates using tiny, fully wristed instruments.  A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci system in real time to bend and rotate the instruments with precision.

It’s important to remember that Intuitive does not provide medical advice. After discussing all options with your doctor, only you and your doctor can determine whether surgery with da Vinci is appropriate for your situation. You should always ask your surgeon about his or her training, experience, and patient outcomes.

More about da Vinci

Why surgery with da Vinci?

A review of published studies suggests that potential benefits of a hysterectomy for cancer with da Vinci technology include:

• Compared to patients who had an open procedure, patients who had a hysterectomy with da Vinci experienced fewer complications^8-11 and stayed in the hospital for less time.^8-12
• Compared to patients who had a laparoscopic procedure, patients who had a hysterectomy with da Vinci had fewer, or similar, complications^8,10-12 and stayed in the hospital for the same, or less, time.^8,10-12 
• Surgeons may switch to an open procedure when doing a procedure with da Vinci with the same likelihood, or possibly less, compared to a laparoscopic surgery.^8,10-12

All surgery involves risk. You can read more about associated risks of hysterectomy for cancer here.

Questions you can ask your doctor

• What medical options are available for my cancer? 
• What happens if I don’t get surgery?
• What are the differences between open, laparoscopic, and robotic-assisted surgery?
• Can you tell me about your training, experience, and patient outcomes with da Vinci?
• How will I feel after surgery?

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Resources for learning more

Hysterectomy surgery brochure Take away information about hysterectomy surgery for cancer with da Vinci technology in our brochure designed for patients and families. About your options

Gynecologic surgery with da Vinci  Robotic-assisted surgery with da Vinci technology is used in many different types of procedures by gynecology surgeons. About the specialty

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^{1. U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on November 2017 submission data (1999-2015): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; www.cdc.gov/cancer/dataviz, June 2018.}

^{2. Signs and Symptoms of Endometrial Cancer. American Cancer Society. Web. 21 January 2019} 

^{3. Signs and Symptoms of Ovarian Cancer. American Cancer Society. Web. 21 January 2019} 

^{4. Tests for Endometrial Cancer. American Cancer Society. Web. 21 January 2019.} 

^{5. Tests for Ovarian Cancer. American Cancer Society. Web. 21 January 2019.} 

^{6. Treating Endometrial Cancer. American Cancer Society. Web. 21 January 2019.} 

^{7. Treating Ovarian Cancer. American Cancer Society. Web. 21 January 2019.} 

^{8. O'Neill, M., et al. (2013). Robot-assisted hysterectomy compared to open and laparoscopic approaches: systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 287: 907-918.} 

^{9. O'Sullivan, S. (2011). HIQA Ireland Health technology assessment of robot-assisted surgery in selected surgical procedures.}

^{10. Ran, L., et al. (2014). Comparison of robotic surgery with laparoscopy and laparotomy for treatment of endometrial cancer: a meta-analysis. PLoS ONE. 9: e108361.} 

^{11. Reza, M., et al. (2010). Meta-analysis of observational studies on the safety and effectiveness of robotic gynaecological surgery. British Journal of Surgery.} 

^{12. Gaia, G., et al. (2010). Robotic-assisted hysterectomy for endometrial cancer compared with traditional laparoscopic and laparotomy approaches: a systematic review. Obstetrics and Gynecology. 116: 1422-1431.} 

Disclosures and Important Safety Information

Surgical Risks

Risks associated with hysterectomy, cancer (removal of the uterus and possibly nearby organs) include injury to the ureters (the ureters drain urine from the kidney into the bladder), vaginal cuff problem (scar tissue in vaginal incision, infection, bacterial skin infection, pooling/clotting of blood, incision opens or separates), injury to bladder (organ that holds urine), bowel injury, vaginal shortening, problems urinating (cannot empty bladder, urgent or frequent need to urinate, leaking urine, slow or weak stream), vaginal fistula (abnormal hole from the vagina into the urinary tract or rectum), vaginal tear or deep cut.

Important Safety Information

Patients should talk to their doctor to decide if da Vinci® surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options and associated risks in order to make an informed decision. 

Serious complications may occur in any surgery, including da Vinci surgery, up to and including death. Serious risks include, but are not limited to, injury to tissues and organs and conversion to other surgical techniques which could result in a longer operative time and/or increased complications. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.intuitive.com/safety. 

Individuals' outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience.

da Vinci Xi® System Precaution Statement

The demonstration of safety and effectiveness for the specific procedure(s) discussed in this material was based on evaluation of the device as a surgical tool and did not include evaluation of outcomes related to the treatment of cancer (overall survival, disease-free survival, local recurrence) or treatment of the patient’s underlying disease/condition. Device usage in all surgical procedures should be guided by the clinical judgment of an adequately trained surgeon. 

Medical Advice and Locating a Doctor

Patients should talk to their doctor to decide if da Vinci surgery is right for them. Other options may be available and appropriate. Only a doctor can determine whether da Vinci surgery is appropriate for a patient’s situation. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision.

Surgeons experienced with the da Vinci system can be found using the Surgeon Locator at www.davincisurgery.com. Intuitive Surgical provides surgeons training on the use of the da Vinci system but does not certify, credential or qualify the surgeons listed in the Surgeon Locator.

Published Evidence

In order to provide benefit and risk information, Intuitive Surgical reviews the highest available level of evidence on urologic procedures. Intuitive Surgical strives to provide a complete, fair and balanced view of the clinical literature. However, our materials should not be seen as a substitute for a comprehensive literature review for inclusion of all potential outcomes. We encourage patients and physicians to review the original publications and all available literature in order to make an informed decision. Clinical studies are typically available at pubmed.gov.

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