The short answer: Before you agree to a robotic hysterectomy (robotic bachedani nikalne ka operation, बच्चेदानी निकालने का ऑपरेशन), ask about five things: the surgeon’s experience, whether the operation is for cancer and which cancer, what happens if the surgery has to switch to open, whether sentinel lymph node mapping will be used, and the follow-up plan. The robot is a tool; the surgeon does the operation. Robotic surgery is a good option for many women, for example most early womb (endometrial) cancers. For cervical cancer, however, open surgery is the standard for most women, so the most important question is whether robotic surgery is right for your type and stage of cancer.
On this page
- 1. How many robotic hysterectomies has the surgeon personally performed?
- 2. Is the surgery for cancer or for benign disease?
- 3. What is the conversion-to-open rate at this centre?
- 4. Will sentinel lymph node mapping be used?
- 5. What is the post-discharge follow-up protocol?
1. How many robotic hysterectomies has the surgeon personally performed?
Experience matters. Complex cancer operations generally go better when the surgeon and team do them regularly. Ask how many operations of this exact type (for example, robotic surgery for womb cancer) the surgeon personally does each year, and how their results are checked. A good surgeon will be comfortable answering.
2. Is the surgery for cancer or for benign disease?
This changes the whole operation. A simple hysterectomy for non-cancer problems such as fibroids or adenomyosis removes the womb and is often done by a gynaecologist. Surgery for cancer is different: it may include removing the tissue beside the cervix (the parametrium) and lymph nodes (glands), and it should be planned by a gynaecological oncologist. The type of cancer also decides whether robotic surgery is a good choice at all:
- Womb (endometrial) cancer: robotic or keyhole surgery suits most early womb cancers.
- Ovarian cancer: robotic surgery may suit selected early cases; advanced ovarian cancer usually needs open surgery.
- Cervical cancer (bachedani ke muh ka cancer): open radical hysterectomy is the standard for most women. A large 2018 study (the LACC trial) found worse survival after keyhole and robotic radical hysterectomy than after open surgery, so robotic surgery is considered only for selected small tumours (usually under 2 cm), after this evidence has been discussed with you.
So ask: “Is robotic surgery the right approach for my type and stage of cancer, and what would open surgery mean for me?” Our page on when robotic surgery is appropriate explains more.
3. What is the conversion-to-open rate at this centre?
Sometimes a robotic operation has to be changed to open surgery (a cut in the tummy) partway through, for example because of bleeding, scar tissue (adhesions) or unexpected findings. This is done for your safety. Ask how often it happens at the centre, and make sure you understand before surgery that it could happen to you.
4. Will sentinel lymph node mapping be used?
In sentinel lymph node mapping, a dye (often a green fluorescent dye called ICG) shows the first lymph node or nodes that the cancer would drain to, so that fewer nodes may need to be removed. It is widely used in early womb cancer and in selected small cervical cancers. Removing fewer nodes may lower the risk of long-term leg swelling (lymphoedema). It is not suitable for everyone, so ask whether it is an option for you.
5. What is the post-discharge follow-up protocol?
A good surgical team has a clear follow-up plan: first review at 1-2 weeks, then 3-monthly for 2 years, then 6-monthly to 5 years. Ask who is responsible for follow-up, how to reach the surgeon for concerns, and what symptoms warrant immediate contact.
What to do next
Write these five questions down and take them to your appointment. Our guide to preparing for a specialist appointment lists the reports to bring. Want a second opinion before scheduling robotic surgery? Dr. Nishtha Tripathi Patel offers independent review of proposed treatment plans. Call or WhatsApp +91 76988 00333, or book a consultation.
Related
External reference: ESGO Cervical Cancer Surgical Recommendations.
FAQs
How many robotic hysterectomies has the surgeon personally performed?
Experience matters: complex cancer operations generally go better when the surgeon and team do them regularly. Ask how many operations of this exact type the surgeon does each year and how their results are checked.
Is the surgery for cancer or for benign disease?
A simple hysterectomy for fibroids or adenomyosis is a different operation from cancer surgery, which may include the tissue beside the cervix and lymph nodes and should be planned by a gynaecological oncologist. Robotic surgery suits most early womb cancers. For cervical cancer, open radical hysterectomy is the standard for most women; robotic surgery is considered only for selected small tumours (usually under 2 cm) after discussing the 2018 LACC trial.
What is the conversion-to-open rate at this centre?
Sometimes a robotic operation has to be changed to open surgery partway through, for example because of bleeding, scar tissue or unexpected findings. This is done for your safety. Ask how often it happens at the centre, and understand before surgery that it could happen to you.
Will sentinel lymph node mapping be used?
A dye shows the first lymph nodes the cancer would drain to, so fewer nodes may need removing, which may lower the risk of leg swelling (lymphoedema). It is widely used in early womb cancer and in selected small cervical cancers, but it is not suitable for everyone. Ask whether it is an option for you.
What is the post-discharge follow-up protocol?
A good surgical team has a clear follow-up plan: first review at 1-2 weeks, then 3-monthly for 2 years, then 6-monthly to 5 years. Ask who is responsible for follow-up, how to reach the surgeon for concerns, and what symptoms warrant immediate contact.
Is robotic surgery better or safer than open surgery for cervical cancer?
Not for most women. The 2018 LACC trial found that women with early cervical cancer who had keyhole or robotic radical hysterectomy had their cancer return more often, and lower survival, than women who had open surgery. Robotic surgery does mean smaller cuts and a quicker recovery, and it remains a good option for many other gynaecological cancers, such as most early womb cancers. For cervical cancer, open surgery is the standard; robotic surgery is considered only for selected small tumours (usually under 2 cm) after this evidence has been discussed with you.
Reviewed by Dr. Nishtha Tripathi Patel, MBBS, DGO, DNB, Fellowship Gynaecological Oncology, ESGO-certified.