Robotic Assisted Surgery (RAS) in gynaecology

Patient information factsheet

About this leaflet

This leaflet is for patients who might be having robotic-assisted gynaecological surgery.
It explains what robotic surgery is. It also explains what happens before and after your operation.
It covers the possible benefits and risks. It tells you where to get help.
This is general information and should be read together with information about your own operation.

Key points about robotic assisted surgery

Robotic-assisted surgery (RAS) is a type of keyhole surgery.
Your Surgeon is in control of the instruments at all times. The robot does not perform the operation on its own.
This system helps Surgeons perform keyhole surgery with greater precision.
The benefits are like those of other keyhole surgeries.
For some patients, these benefits may include smaller cuts, less pain, less blood loss, a lower risk of infection and a shorter hospital stay.
They can also result in a faster return to normal activities compared with open surgery.
RAS is not suitable for everyone.
Your Surgeon will discuss all the different options available to you including robotic-assisted, standard laparoscopic (keyhole), vaginal, open or non-surgical treatments. They will decide what is most appropriate for you.
All surgery has risks.
The risks of robotic-assisted surgery are similar to those of standard surgical techniques.
Before your operation, your healthcare team will explain the risks related to your surgery and your individual health.
They will answer any questions you have. You will then be asked to sign a consent form.

What is robotic assisted gynaecological surgery?

Robotic-assisted surgery is a type of keyhole surgery.
Instead of one large cut, the Surgeon makes several small cuts in your stomach area (abdomen).
A high-definition 3D camera (to see clearer) and small surgical instruments are passed through these cuts.
In robotic-assisted surgery, the instruments are attached to a robot, and the Surgeon controls it.
This gives the Surgeon a bigger (magnified), clearer view and more precise movement when operating in the pelvis (lower tummy).

Which gynaecology operations may be carried out robotically?

Robotic-assisted surgery may be used for different planned gynaecological operations.
Whether it is suitable for you depends on your condition, any past surgery, body shape, anaesthetic risk, how complex the operation is, and your Surgeon�s judgement.
It can be used for:
- Hysterectomy: removal of the womb, sometimes with removal of the cervix, fallopian tubes or ovaries.
- Myomectomy: removal of fibroids while keeping the womb.
- Ovarian or fallopian tube surgery: such as removal of an ovarian cyst, ovary or fallopian tube.
- Endometriosis or adhesiolysis surgery: where areas of endometriosis or scar tissue are treated.
- Selected pelvic floor or prolapse procedures: if offered by your clinical team.
- Other complex pelvic procedures: where a robotic-assisted approach is judged to be helpful.

Why might robotic-assisted surgery be offered?

Robotic-assisted surgery may help the Surgeon do delicate work in the pelvis using a magnified 3D view and very precise movements.
For some patients, it may make keyhole surgery possible even when the operation is complex.

Potential benefit	What this may mean for you
Small cuts	Usually several small abdominal cuts rather than one large cut.
Less pain for some patients	Many people need less strong pain relief than after open surgery, although discomfort is still expected.
Less blood loss	Some patients have a lower chance of needing a blood transfusion compared with open surgery.
Shorter hospital stay	Some patients go home the same day or the next day, depending on the operation and recovery.
Quicker recovery	Many people return to normal activities sooner than after open surgery, but recovery varies.
Smaller scars	The cuts usually heal as small marks on the abdomen.

Are there any risks?

The risks of robotic-assisted gynaecological surgery are no higher than the risks with traditional techniques.
Some risks depend on the exact procedure you are having.
Your Surgeon and Anaesthetist will discuss your individual risks with you.
The general risks of surgery, which are not specific to robotic-assisted surgery, are explained below.

Anaesthetic risks

All operations need an anaesthetic assessment before surgery.
Tell your team about any allergies you have, past problems with anaesthesia and all medicines you take.

Bleeding

You may have bleeding during or after surgery.
A blood transfusion is uncommon but may be needed.

Infection

You may get an infection in the wounds, your urine, your chest or inside your pelvis.
Antibiotics may be needed.

Injury to nearby organs

For example: bladder, bowel, ureters (two thin tubes in your body that carry urine (pee) from the kidneys down to the bladder), blood vessels or nerves.
Further treatment or another operation may be needed.

Blood clots

Clots can form in the legs or lungs.
You may be given stockings, compression boots and/or blood-thinning injections to reduce this risk.

Pain, bruising and shoulder-tip pain

Wind-like discomfort is common after keyhole surgery and usually settles.

Urinary symptoms or catheter use

Some patients need a catheter (a thin, soft tube that is placed into the bladder that helps drain urine (pee) into a bag) during or after surgery.

Conversion to open surgery

A larger cut may be needed if it is safer to continue the operation that way.

Equipment or access issues

Rarely, the robotic system may not be suitable or available on the day of surgery.
If this happens, the plan may change to standard keyhole surgery or open surgery.

Recovery taking longer than expected

Fatigue (tiredness) and discomfort can last for several weeks, especially after major surgery.

Alternatives to robotic-assisted surgery

Depending on your condition, alternatives may include:

No treatment or �watchful waiting�, where this is safe
�Watchful waiting� is where your doctors keep a close eye on your condition over time: You may have regular check-ups or scans, and treatment is only started if your condition changes or gets worse
Medicines, hormonal treatment, pain management, physiotherapy or other non-surgical care
Standard laparoscopic keyhole surgery without robotic assistance
Vaginal surgery, where appropriate
Open abdominal surgery through a larger cut
Radiology treatments for selected conditions, such as uterine artery embolisation for fibroids, where appropriate.
You can ask your Surgeon why a robotic-assisted approach is being recommended and what the pros and cons are compared with other options.

Before your operation

Questions you may want to ask

What operation am I having and why is it needed?
Why is robotic-assisted surgery being recommended for me?
What are my alternatives, including not having surgery?
What are the main risks for me personally?
How long am I likely to stay in hospital?
How long should I plan to be off work, driving, exercise and sex?

Pre-assessment appointment

You will usually have a pre-assessment appointment before your surgery.
This may include questions about your health, medicines, allergies and previous operations.
You may have blood tests, swabs, an ECG (electrocardiogram), urine tests or other investigations depending on the type of operation you are having and on your health.

Eating and drinking

You will be given instructions about when to stop eating and drinking before your anaesthetic.
It is important to follow these instructions.
If you do not, your operation may need to be delayed or cancelled for safety reasons.

Pregnancy and contraception

Please tell your team if you are or could be pregnant.
You may be asked to provide a urine sample for a pregnancy test on the day of surgery.

Before the operation, a member of the surgical team will explain the planned procedure, the benefits, risks and alternatives, and answer your questions.
You will be asked to sign a consent form if you decide to go ahead.

On the day of surgery

You will be admitted to the hospital ward or Day Surgery Area and will meet the nursing, anaesthetist and surgical teams.
You will have a general anaesthetic, so you will be asleep during the operation.
You may have a catheter in the bladder and compression devices (i.e. socks/stockings/sleeves) on your legs to help reduce the risk of blood clots.
The Surgeon makes small cuts in the stomach area and places the camera and instruments through these cuts.
The robotic arms are connected to the instruments. The Surgeon controls the instruments from a control station in the operating room.
At the end of the operation, the instruments are removed and the small cuts are closed with stitches or glue
The length of the operation depends on the type and complexity of surgery. Your team will discuss what to expect for your specific procedure.

After your operation

Recovery

You will wake up in the recovery area and then return to the ward or Day Surgery Area.
Nurses will check your blood pressure, pulse, temperature, breathing, pain score, wounds, bleeding and urine output.

Pain relief and nausea

Some pain, cramping, bloating or shoulder-tip pain is common after keyhole surgery.
You will be offered pain relief and anti-sickness medicine if needed.
Please tell staff if your pain or nausea (feeling sick) is not controlled.

Eating, drinking and moving

You will usually be encouraged to drink, eat lightly and get out of bed as soon as it is safe.
Gentle walking helps create movement in your body and reduces the risk of blood clots and chest infection. It can also help your bowels recover from the anaesthetic so that you can go to the toilet.

Going home

Some patients go home the same day; others stay overnight or longer.
This depends on the operation, your general health, pain control, whether you can pass urine (pee), and whether there are any concerns after surgery.

At home	General advice
Wounds	Keep wounds clean and dry. Follow the instructions you are given about dressings and bathing or showering.
Bleeding or discharge	Light vaginal bleeding or discharge can be normal after some operations. Use sanitary pads rather than tampons until advised.
Bowels	Constipation is common after surgery and painkillers. Drink fluids, eat fibre and use laxatives if prescribed.
Driving	Do not drive until you can move comfortably, perform an emergency stop, are not taking sedating painkillers, and your insurer's rules are met.
Work and activity	Time off work varies. Most people need 2 to 6 weeks depending on the operation and type of work. Avoid heavy lifting until advised.
Exercise and sex	Restart gradually. Your Surgeon will advise when it is safe to resume sex, swimming, heavy exercise and lifting.

When to seek medical advice

Call NHS 111, your GP, or attend the Emergency Department if you are unwell.
Call 999 for life-threatening symptoms such as severe breathing difficulty, if you collapse (faint) or experience chest pain.

Seek medical advice if you have:	Why this matters
Heavy vaginal bleeding	For example: soaking pads, passing large clots, or bleeding that worries you.
Fever or feeling very unwell	This may suggest infection, especially with worsening pain or shivering.
Increasing abdominal pain	Pain that is getting worse rather than better needs assessment.
Red, hot, swollen or leaking wounds	These can be signs of wound infection.
Difficulty passing urine	Especially if you cannot pass urine or have severe bladder pain.
Calf pain, leg swelling or redness	These can be signs of a blood clot in the leg.
Chest pain or shortness of breath	These can be signs of a clot in the lung or another serious problem.

Follow-up

Your follow-up plan depends on your operation and recovery.
You may have a telephone appointment, clinic appointment, or instructions to contact the team if you have concerns.
Please make sure the hospital has your correct contact details before you go home.

Contact our service

If you have any questions, please contact the Women�s Health department:

Telephone: 020 7288 3118 (Monday to Friday 8am to 5pm).

Email: whh-tr.womenshealthadmin@nhs.net

Published:

29 Jun 2026

Review:

29 Jun 2028

Reference:

SC/RASGyane/01