Robotic Surgery in Gynecology 

Robotic Surgery: Smaller Incisions, Greater Precision, Faster Recovery 

If you’ve been told you may need surgery, you probably have questions and maybe a few worries. That’s completely normal. Our goal at The Woman’s Health Pavilion is to give you clear, honest information about every option available to you, so that together we can choose the one that’s right for you. 

For many women, robotic surgery offers a way to treat gynecologic conditions through a few tiny incisions instead of one large one, with less pain and a quicker return to the life you love. Our approach is simple: compassionate care married to meticulous skill. You’ll be heard, your questions will be answered, and the decision will always be yours. 

What Is Robotic Surgery? 

The first thing to know: the robot does not operate on its own. We perform every step of your surgery. The da Vinci system is a sophisticated surgical tool that the surgeon controls completely, from start to finish. 

Here’s how it works: 

Through a few small incisions—usually 5-8mm in size— we place a tiny camera and slender surgical instruments inside your body. The surgeon then sits at a console just a few feet from you and guides those instruments with their hand movements. 

The system gives us: 

• A magnified, 3D, high-definition view of your anatomy, so we can see fine detail, including tiny areas of endometriosis, delicate blood vessels and nerves 
• Instruments that bend and rotate like a human wrist, but with a greater range of motion, allowing us to work precisely in tight spaces 
• Steadiness and control, with technology that supports smooth, precise instrument movements. 

Think of it as the difference between working with a flashlight and working in full daylight, with a very fine set of tools. Your body is treated gently; the precision is what makes the difference. 

Why Choose Robotic Surgery? 

Compared with traditional, open surgery (a larger abdominal incision), the robotic approach generally means: 

• Less pain after surgery and less need for strong pain medication 
• Smaller scars and a lower risk of wound problems 
• A shorter hospital stay and often same-day or next-day discharge 
• A faster recovery and an earlier return to work, exercise and family life 
• Less blood loss in many cases 

What about standard (“straight-stick”) laparoscopy?  

This is also a minimally invasive procedure, and it’s an excellent option for many straightforward procedures. Where robotics really shines is in the more complex cases: large or multiple fibroids, deep endometriosis, extensive scar tissue (adhesions), and surgery in patients where space and access are challenging. In these situations, the 3D vision, wristed instruments and added precision let me do careful, thorough work, including delicate suturing, through those same small incisions. 

Seeing more with fluorescence imaging 

The da Vinci system includes a built-in fluorescence imaging mode (called Firefly). During endometriosis surgery, a small amount of a safe, well-established imaging dye (indocyanine green) is given through an IV. Under the robot’s near-infrared light, tissue lights up in a way that can help us spot areas of endometriosis that are hard to see in regular light. That can mean a more thorough, complete treatment. The same technology can also help us clearly identify important structures, such as the ureters and the bladder and check blood flow to tissue during surgery. 

More precision where it counts 

In complex surgery, robotics also offers: 

• Finer suturing. The wristed instruments make it easier to repair the uterus in careful layers after fibroid removal. 
• Steady, precise work in challenging situations, such as a larger uterus, scar tissue from prior surgery, or a higher body weight, where straight instruments can be harder to maneuver. 
• More patients who can avoid large incisions. Cases that once might have required open surgery can often be done through small incisions. 

Here’s how the three approaches compare: 

	Open surgery	Standard laparoscopy	Robotic surgery
Incision	One large incision	Several small incisions	Several small incisions
Visualization	Direct view	2D camera	3D, magnified HD view
Instrument motion	Hand-held	Straight, rigid instruments	Wristed instruments with a wide range of motion
Fluorescence imaging (to highlight endometriosis, ureters, blood flow)	Not available	Available on some systems	Built in (Firefly with ICG dye)
Blood loss	Highest	Significantly less than open	Significantly less than open
Post-op pain	Highest	Lower	Lower
Hospital stay	Longest	Short, often same-day or next day	Short, often same-day or next-day
Recovery	Longest	Faster	Faster
Best suited for	Select cases where a minimally invasive approach isn’t possible	Straightforward procedures	Complex procedures and challenging anatomy

Every patient is different and the best approach depends on your condition, your anatomy and your history. Robotic surgery isn’t right for everyone and we will always tell you honestly if another option would serve you better. 

A More Comfortable Recovery: Enhanced Recovery After Surgery (ERAS) 

Good surgery includes good pain control. We use an Enhanced Recovery After Surgery (ERAS) approach, a set of evidence-based steps before, during and after your procedure. The goals are for you to experience less pain, less need for opioid (narcotic) medication, less nausea, and a faster return to eating, walking and normal life. 

• Before surgery: Clear instructions on eating and drinking, with no unnecessary long fasting and no routine bowel prep for most benign procedures. You’ll know exactly what to expect. 
• During surgery: A combination of non-opioid pain medicines and numbing medicine, so pain is prevented before it starts, along with measures to limit nausea. 
• After surgery: Scheduled non-opioid pain relievers, with stronger medication only if you need it and in the smallest amount necessary. You’ll be eating, drinking and walking early and we avoid drains and tubes whenever possible. 

Conditions We Treat with Robotic Surgery 

We care for the full range of benign gynecologic conditions using a minimally invasive robotic approach, including: 

• Uterine fibroids.Fibroids can cause heavy periods, pressure, and pain. Robotic fibroid removal removes them while preserving your uterus; for some women, hysterectomy is the right choice. 
• Abnormal uterine bleeding. Heavy, prolonged or unpredictable bleeding is never something you have to just live with. We’ll find the cause and discuss every option. 
• Adenomyosis. When the uterine lining grows into the muscular wall of the uterus, it can cause painful, heavy periods. Surgery can bring lasting relief. 
• Endometriosis. Careful robotic excision removes endometriosis implants and scar tissue, and the magnified view helps us see disease that may be easily missed otherwise.  
• Ovarian cysts. Robotic cystectomy removes a cyst while sparing healthy ovarian tissue whenever possible. 
• Chronic pelvic pain.Long-standing pain deserves a real answer. Surgery isn’t always the answer, but when it is, a minimally invasive approach can both diagnose and treat. 

The procedures we perform robotically include but is not limited to hysterectomy, myomectomy, excision of endometriosis and ovarian cystectomy, among many others. 

Your Options and What to Expect 

Surgery is not typically the conversation we have. Depending on your condition, there may be medication(s), hormonal therapy, pelvic floor therapy, or less invasive procedures that make sense to try first. We’ll talk through all of them, including the pros, cons and likely results of each and you can take the time you need to decide. When surgery is the right step, here’s what the journey looks like: 

1. Your consultation. We’ll review your history, symptoms and any imaging, talk about your goals (including future fertility, if that matters to you), and go over every option. 
2. Preparing for surgery. You’ll get clear instructions on testing, medications, eating and drinking, and what to bring. Our team is always a phone call or Klara message away. 
3. Surgery day. You’ll be under general anesthesia and comfortable throughout. Your surgery takes place at Plainview Hospital, part of Northwell Health. 
4. Going home. Many women go home the same day or the next morning with a clear plan for pain control and activity. 
5. Recovery. Most women are up and walking right away and gradually resume normal activities over the following weeks. Your timeline depends on the procedure, and we’ll give you specific guidance for yours.  
6. Follow-up. We’ll check in after surgery to make sure you’re healing well and answer any questions. 

Frequently Asked Questions 

Does the robot perform the surgery?

No. The surgeon performs your surgery. The robot simply translates their hand movements into precise movements of tiny instruments inside your body. It cannot act on its own. 

Is robotic surgery safe?

Robotic surgery has been used successfully for many years and it’s backed by extensive research. Like any surgery, it carries risks, such as bleeding, infection, injury to nearby organs and anesthesia-related risks. We will review these with you openly. In rare cases, if it’s safest for you, a procedure may need to be completed through a larger incision and we’ll discuss that possibility beforehand. 

Will I have scars?

Your incisions are small (5-8mm) and they typically fade well over time. 

How much pain should I expect?

Some soreness is normal, including shoulder discomfort from the gas used during surgery. We use a special pain protocol called Enhanced Recovery After Surgery or ERAS. This pain management protocol affords you a more comfortable post-operative pain experience. Most women find that their pain control is far more manageable than they expected and we’ll make sure you have a plan to stay comfortable. 

How long will I be in the hospital?

Often you can go home the same day or the next morning, depending on your procedure and your health. 

When can I return to work and my normal routine?

It varies by procedure and we will give you specific guidance. In general, recovery is considerably quicker than with open surgery. 

Can I keep my uterus or ovaries?

Often, yes. Many conditions, including fibroids, endometriosis and ovarian cysts, can be treated with uterus- and ovary-sparing procedures. If hysterectomy is the best option, we’ll talk about whether your ovaries should stay or go, and why. 

I want to have children in the future. Are my options limited?

Not necessarily. If fertility matters to you, tell us at the start. It will shape everything we discuss. 

Will my insurance cover it?

Robotic surgery is covered by most major insurance plans when it’s medically appropriate. Our office staff will help you verify your benefits before your procedure.  

Am I a candidate for robotic surgery?

Most women who need gynecologic surgery are, but the only way to know for sure is to talk with you and do an exam. Your consultation is the place to start. 

Let’s Talk 

You deserve to feel well and you deserve answers. Whether you’re exploring options for the first time or looking for a second opinion, our da Vinci trained surgeons, Dr. Stephen Scarantino and Dr. Stephanie Killeen, are happy to meet with you, listen to your story, and help you find the path that’s right for you.   

Call or contact us to schedule a consultation.