Da Vinci Hysterectomy – Side Effects & Complications

The da Vinci robotic surgical system was intended to minimize some of the risks of hysterectomy surgery. While it has helped a number of patients, it may also cause serious side effects and complications.

Hysterectomy is a surgery to remove a woman’s uterus.  It is the second most common type of surgery for woman in the United States today and is surpassed only by cesarean section surgery Approximately 600,000 hysterectomies are performed each year.

Da Vinci hysterectomy is performed as an alternative to traditional methods which may include open surgery, laparoscopic surgery or vaginal hysterectomy.  It uses robot-assisted technology in which a console is used by the surgeon who can perform precise and complex manipulations of instruments through wrist action.

Though, in ideal circumstances, da Vinci robotic technology may offer improvement over open abdominal surgery, it still poses a risk of complications, some of which are new and unique to the procedure.  When compared to traditional laparoscopic surgery, it may not offer improvement and is considerably more expensive.

Da Vinci Robot Hysterectomy Side Effects and Complications

There are a number of complications that have been reported after undergoing Da Vinci hysterectomy surgery. Some of the complications are the same as other types of hysterectomy, but others are only experienced during a da Vinci procedure.

Complications of da Vinci robot hysterectomy can include:

Vaginal cuff dehiscence

During a radical or total hysterectomy procedure, both the uterus and the cervix are removed.  This requires closure of the upper portion of the vagina, where the cervix used to be. Da Vinci hysterectomy may result in vaginal cuff tear or vaginal cuff dehiscence which occurs at the area where the vaginal cuff was closed.  Vaginal cuff dehiscence occurs more frequently following hysterectomies that are performed through laparoscopic incisions like the da Vinci procedure than through abdominal or vaginal hysterectomy.

Vaginal cuff dehiscence should be treated as a medical emergency.  If left untreated it may result in bowel evisceration in which the intestines fall through the opening.

Symptoms of vaginal cuff dehiscence may include:

  • Abdominal pain
  • Pelvic pain
  • Vaginal discharge or bleeding
  • Fluid rush out of the vagina
  • Feeling of large mass in vaginal or pelvic area
  • Sensation of pressure in vaginal or pelvic region

Severe bleeding

Open surgery may hold a higher risk for significant blood loss in hysterectomy, however severe bleeding may still be of significant concern in a da Vinci procedure.  It is often necessary for the surgeon to cut into veins or blood vessels in order to remove the uterus, cervix and ovaries. This may result in internal bleeding which requires cauterization, sutures or other methods to control.  If bleeding goes unnoticed or occurs after the procedure, significant blood loss may occur and the risk of infection or other complications may increase.

Internal organ tear or perforation

During hysterectomy, other abdominal organs may be punctured or perforated.  Hysterectomies performed with da Vinci robotic surgery system may be done at increased risk of organ perforation than open or abdominal surgery as space and vision field of operation may be limited during the procedure.  In addition, inadvertent movement with he robot-assisted control arm may result in nicks or cuts to organs which can result in complications beyond what is intended.

Conversion to open surgery

If complications occur during a da Vinci hysterectomy, or the machinery malfunctions, the surgeon may be forced to convert the procedure into a traditional open or abdominal surgery.  This will expose the patient to more risks than simply performing the abdominal hysterectomy would have caused. The patient will face risk of bleeding, increased anesthesia time, significant abdominal scarring, internal scar tissue, and significant recovery time.

Da Vinci robotic surgery procedures generally require that patients are placed in a head down position which may result in fluid accumulation in the lungs.  Due to the fluid buildup, the patient may require intubation to provide proper oxygenation. Patients who have da Vinci hysterectomy may be at increased risk for pneumonia due to fluid accumulation and intubation equipment.

Reasons for Hysterectomy

Hysterectomy involves surgical removal of the uterus and may be done for a number of reasons.  It may be performed to improve a patient’s medical condition or may be required as part of a life-saving treatment.

Da Vinci hysterectomy surgery is used to correct or treat:

  • Fibroids
  • Prolapse of the uterus
  • Endometriosis
  • Cancer of the cervix, ovaries, endometrium, or uterus
  • Adenomyosis
  • Severe pelvic pain or vaginal bleeding

There are three main types of hysterectomies, radical, total, and partial.

  • Radical hysterectomy – most often performed to eliminate cancer and involve removal of entire uterus, cervix and upper part of the vaginal.  Also involve removal of ovaries and fallopian tubes.
  • Total hysterectomy – removes the uterus and cervix and often includes removal of fallopian tubes and ovaries.
  • Partial hysterectomy – involves removal of the uterus or part of the uterus but leaves the cervix intact.

Cost of a Vinci Robot Assisted Hysterectomy

Da Vinci robotic hysterectomy is perceived as being safer and a more efficient form of surgery.  Many women may also believe that it is less expensive than traditional surgery but this is not often the case.  Da Vinci robot surgeries are generally more expensive than regular laparoscopic procedures and may be more expensive than vaginal hysterectomy.  In addition, if the patient requires conversion to an abdominal hysterectomy, the costs may be incrementally higher.

Surprisingly, the da Vinci system which is used for robot-assisted hysterectomy costs the hospital upwards of $2 million and requires a commitment to yearly maintenance costs of more than $100 thousand.  The training of surgeons may also be a significant expense as many physicians have stated that they are not comfortable with the minimum training offered and require additional training sessions to become proficient.

Compensation for da Vinci Robot Hysterectomy Injuries

While most Da Vinci assisted hysterectomy surgeries may be completed successfully, there have also been many incidents reported to the FDA. Most of these had to do with either product malfunction or surgeon inexperience.  People who have been harmed by a da Vinci robotic hysterectomy may be eligible for compensation for their injuries and should seek legal advice.

Notwithstanding claims relating to this product, the drug/medical device remains approved by the U.S. FDA.