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This information aims to help answer some of the questions that you may have about having a robotic hysterectomy (removal of womb and cervix) with or without bilateral salpingo-oophorectomy (removal of tubes and ovaries). It explains the benefits and risks of the procedure, your alternative options for treatment as well as what you can expect when you come into hospital and afterwards.

If you have any questions and concerns, please do not hesitate to speak to your doctor or named nurse.

A robotic hysterectomy is when laparoscopic (keyhole) surgery is performed using robotic assistance to remove the uterus (womb). Sometimes you will decide with your doctor to remove the ovaries and fallopian tubes at the same time (known as a bilateral salpingo-oophrectomy, or BSO).

The method of performing a hysterectomy by means of keyhole surgery at UCLH is an established technique. Laparoscopic procedures are generally preferred to ‘open’ procedures (where a bigger cut is needed on the tummy), as the recovery is faster. Robotic surgery involves the use of robotic arms to perform the laparoscopic procedure and enables surgeons to operate with enhanced vision, precision, and control. The procedure is performed by the surgeon, not the robot, who manipulates the robotic arms.

Robotic hysterectomy is performed under general anaesthesia. It involves use of a number of "ports" or small incisions which allow access to the womb and ovaries.

Whether you have a traditional laparoscopic procedure, or a robotic procedure, there is a small chance that your procedure may need to be converted to an open operation. Once the operation begins the surgeon may find that it is not possible to proceed through the keyholes and so may need to make a larger incision in your tummy to remove the uterus. Your healthcare professional will be able to guide you how likely this is.

Hysterectomy for benign conditions can be recommended in patients with endometriosis, adenomyosis, dysfunctional uterine bleeding and fibroids. It can also be recommended in patients with pre-cancerous conditions of uterus or cervix such as atypical endometrial hyperplasia.

Both traditional laparoscopic hysterectomy and robotic hysterectomy are preferred to open hysterectomy as the recovery time is quicker, and the hospital stay is shorter.

Advantages of robotic hysterectomy compared to traditional laparoscopic hysterectomy are:

  • Fewer complications.
  • Less blood loss.
  • Enhanced surgical 3D vision and dexterity of instruments – gives the surgeons high levels of control within the abdomen.
  • Lower risk of conversion to open surgery.

Robotic hysterectomy provides greater benefit in patients with obesity and enlarged uterus (due to fibroids or adenomyosis).

Robotic surgery and laparoscopic surgery have both been used for many years. The gynaecology cancer team at UCLH have carried out robotic laparoscopic surgery for several years with excellent results. Since July 2023 we have introduced this technique for our non-cancer patients who need a hysterectomy for other reasons, because we believe it will improve the outcomes and reduce complications for patients. The surgical team have been trained to use the device and the robot technical team are available to support every procedure.

All treatments and procedures can be associated with complications. The complications of robot surgery are the same as without the robot, as the actual operation being carried out is the same.

Problems that may happen during the operation

During the operation, there may be accidental injury to the ureters (the tubes that drain urine from the kidney into the bladder), the bladder or the bowel. Repairing these injuries may require conversion to an open procedure (with a bigger cut on the tummy) and a longer operation time, as well as a more prolonged recovery.

Usually, these injuries are identified at the time of the operation and repaired immediately. However, sometimes these injuries are small and are missed, and only get noticed when you become unwell in the days following the operation. If this is the case you may need a second operation.

You may bleed heavily during the operation. Occasionally you will need a blood transfusion (donated blood given through a drip) during, or soon after, the operation.


Problems that may happen after the operation

Sometimes in the days and weeks following the operation, the stitches at the top of the vagina can open up, or blood can pool behind the stitches.

In the longer term, there may be descent of the upper part of the vagina, causing a prolapse. The vagina may also be shorter, which can make it uncomfortable to have sex. Occasionally, scarring or infection can cause a channel to open up into the vagina (a fistula) from the bowel or bladder.

Because the womb usually sits right next to the bladder, after the operation, some women experience changes in the way their bladder functions. They may find that need to go pass urine more often, or that they leak urine, or that the flow of the urine is slower.

After any operation, you are more at risk of developing blood clots in your legs or lungs.

You should talk to your specialist doctor to decide if robotic surgery is right for you. You should have the opportunity to discuss all the available information on surgical and non-surgical options, and their risks and benefits, to help you make an informed decision.

If you choose not to have a robotic hysterectomy, but still want to have your womb removed surgically, you may be offered a traditional laparoscopic hysterectomy or an open hysterectomy.

We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with robotic surgery, we will ask you to sign a consent form. This confirms that you would like to have the procedure and understand what it involves.

The medical team will explain all the risks, benefits, and alternatives, and invite you to ask any questions, before they ask you to sign a consent form. If you are unsure about any aspect of your proposed treatment, please do not hesitate to speak with a senior member of the medical or nursing team again.


It is important that there is no possibility of pregnancy when you have this operation. For this reason, we ask you to either abstain from having sex, or use reliable contraception, in the month before your surgery (from the first day of your last period before your operation).

Combined oral contraceptive pills slightly increase your risk of blood clots on the legs or lungs (DVTs or PEs) after surgery. For this reason, you will usually be advised to change to an alternative e.g., condoms or the progesterone only pill, four weeks before the procedure.

Preparing your body for surgery

Some changes can have a really big impact on your recovery, for example:

  • Increasing your exercise: try to do 30 minutes of activity which makes you feel out of breath, at least three times each week.

  • Eating a healthy, balanced diet before surgery and planning easy to cook meals for your recovery.

  • Stopping smoking and alcohol can be hard, but quitting or cutting down before surgery can reduce your hospital stay and improve wound healing.

Preoperative Assessment Clinic

A few weeks before your surgery you will be asked to attend a preoperative assessment appointment. This can be by telephone, or in person in the hospital. You will be asked questions about your health, medical history and home circumstances. Some tests may also be required, for example blood tests, or an ECG (a tracing of your heart rhythm).

You will be given information about the morning of your surgery: when to stop eating and drinking, and if you need to stop taking any of your regular medications.

The day of your surgery

You will receive instructions about the time of your admission, and where to go. If you do not receive these, please contact your team using the contact details below. More information about what to bring to hospital, and what to expect once you arrive, can be found under “Gynaecology Enhanced Recovery Pathway”.

During robotic assisted hysterectomy, your surgeon makes several small incisions (usually four to five), then uses a 3D high-definition camera for a crystal clear, magnified view of your uterus and pelvis.

The surgeon then sits at a console next to you and operates through the incisions using tiny instruments and the camera. Every hand movement your surgeon makes is translated in real time by the robotic system which bends and rotates the instruments so your surgeon can remove your uterus.

Surgery will remove the uterus with or without removing the tubes and ovaries (depending on what was decided). The skin incisions (cuts) are then closed with stitches or special glue as for any other surgery.

Detailed information about what to expect in hospital after an operation, and about your longer-term recovery, can be found under “Gynaecology Enhanced Recovery Pathway”.

When you wake up from the operation, you will have a drip in your arm and a catheter in your bladder. These will usually stay in for about 24 hours. You may also have a drain placed in your tummy to allow additional body fluids (e.g., blood) to drain out, but this is not common.

You may feel drowsy and nauseous from the anaesthesia. Your abdomen may feel painful and bloated. You may also have pain around the shoulders from the gas that is used within the abdomen for the procedure. This will settle within a few days, and can be improved by moving around and taking pain killers.

You will be discharged once you are eating, drinking, passing urine and moving around safely, and when your pain is well-controlled with tablets. This is usually after one to three nights. Occasionally your surgeon may recommend that you stay in hospital a little longer, especially if your surgery was difficult, or if there were complications.

It is important that someone is available to help you get home when you are discharged (e.g., to help carry your bag). You will need to plan in advance for the fact that you won’t immediately be able to do things you usually would do at home, including driving. Our leaflet “Gynaecology Enhanced Recovery Pathway” explains in more detail about what to expect, and what plans you may need to make.

We would suggest that you plan to be off work for six weeks. You may feel able to go back sooner, or you may need longer if your job is very active, or if there were complications.

If you develop the following symptoms once you get home, you should go to your nearest Accident and Emergency Department. They can be signs of complications, for which you may need urgent treatment.

  • High fever.
  • Pain in the abdomen that is getting worse.
  • Swelling of the abdomen that is getting worse.
  • Being unable to pass urine, or passing very little.
  • Swelling, redness, or tenderness in the lower legs.
  • Difficulty breathing, or chest pain.

You will no longer need smear tests if the whole womb was removed. Very occasionally, a ‘subtotal’ hysterectomy will be performed if it would be very difficult or dangerous to remove the cervix: if this is the case this will be explained to you, and you will need to continue having smear tests.

If your ovaries were removed before you had reached the menopause, you are likely to experience new menopausal symptoms. These include hot flushes, night sweats, vaginal dryness and brain fog. To help with these symptoms, and also to protect the strength of your bones (for which the hormone oestrogen, produced by the ovaries, is important), we will discuss the option of HRT (hormone replacement therapy).

If your ovaries are not removed, you are unlikely to experience menopausal symptoms straight away. However, since your periods will stop when your womb is removed, you will not always know when you have reached the menopause. It is therefore worth being aware of the symptoms and signs so that you can consider HRT if they are troublesome.

Please contact us in case of any further queries throughout your care. Email:

Alternatively, you may reach us via MyChart UCLH application using direct message. Please allow at least 72 hours for a reply.

Ward T7 South (if your next of kin wants an update on how you are immediately after the operation, or if you have non-urgent queries when you go home)

Tel: 020 3447 7828 or 020 3447 0712

Pre-operative assessment clinic (PAC) (if you have questions about how to prepare for the operation)

Tel: 020 3347 2504

Surgical reception (if you are running late on the day of your operation)

Tel: 020 3447 3184 or 07939 135323

University College Hospital

235 Euston Road, London NW1 2BU Switchboard: 020 3456 7890