Robot Assisted Laparoscopic Hysterectomy

WHAT YOU SHOULD KNOW:

Robot-assisted laparoscopic hysterectomy (RH) is surgery done through small incisions (cuts) in your abdomen. RH uses a machine controlled by your surgeon. The machine has robotic (mechanical) arms that use small tools to remove your uterus and cervix. Your ovaries, fallopian tubes, top of your vagina, supporting tissues, and some lymph nodes may also be removed. After RH, you will not be able to become pregnant. You will go through menopause if your ovaries are removed.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • During RH, you may bleed too much or get an infection. Your bladder, ureters (tubes that drain urine from your body) or intestines could be cut during surgery. After RH, you may have problems urinating for a while. Your stitches may come apart. You can develop a hernia or abscess (deep infection). Larger than expected cuts in your abdomen may be needed, and you will need more time to recover.

  • Sometimes openings (fistulas) form between the bladder and vagina. Long-term problems with urination may happen if nerves are damaged. You may need more surgery to treat these problems. You may get a blood clot in your leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening. If you have cancer, it may come back, even after surgery. If you do not have the hysterectomy, your signs and symptoms could get worse. Call your caregiver if you are worried or have questions about your care.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Call button: You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.

  • Bowel cleansing: You may be given medicine to drink, or an enema. An enema puts liquid inside your rectum to help empty it of stool .

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

You will lie on your back, with your feet up in stirrups. Caregivers will clean and may remove hair from the surgery area on your abdomen. Sterile (germ-free) sheets will be put over you to keep the area clean. The machine used during RH has robotic (mechanical) arms. Caregivers use the arms to place a laparoscope (a long, thin tube with a light and camera on the end) and other tools inside your abdomen through small cuts. A gas called carbon dioxide is pumped into your abdomen to help caregivers see better. Your caregiver uses the machine to look inside your abdomen, guide the robotic arms, and use the tools to remove the uterus, cervix, or other tissues. These tissues are removed through the cuts in your abdomen or through your vagina. Your caregiver uses the tools to stitch the cuts closed.

After your surgery:

You are taken to a recovery room until you are alert. You will then be taken to your room. Bandages on your cuts help prevent infection. You will need to wear a sanitary pad after surgery. Caregivers will check your bandages and sanitary pad for bleeding. You may also have the following:

  • Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

Medicines:

You may be given the following medicines:

  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Intake and output:

Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

Deep breathing and coughing:

This will help decrease your risk for a lung infection after surgery.

  • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

  • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

You will be able to drink liquids and eat certain foods

once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

Preventing blood clots:

You may need to take medicine to thin your blood. Blood-thinning medicine helps prevent blood clots from forming in your veins. If you have a bleeding disorder or a history of bleeding or blood clots, tell your caregiver. Talk to your caregiver about all of the medicines that you use.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Robot Assisted Laparoscopic Hysterectomy (Inpatient Care)

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