Hysterectomy (removal of uterus) and, especially myomectomy (removal of fibroids) may be associated with significant blood loss. Since Jehovah Witness patients decline blood transfusion, a blood loss may limit the scope of surgery or pose a risk to their life. Elimination, or at least reduction of blood loss is always desired, but it’s of paramount importance in Jehovah Witness patients.
During laparoscopic surgery, intentionally, CO2 gas is insufflated into and maintained at certain pressure within the abdominal cavity (inside the belly). This is aimed to sustain a distended abdominal cavity to create a safe space for the surgeon to perform the operation. One of the additional desired results of such constant CO2 insufflation is partial compression of smaller blood vessels, especially veins, which reduces the inherent blood loss. In contrary, during laparotomic (open belly incision) surgery, blood vessels are not subjected to increased pressure resulting in higher blood loss.
Robotic surgery is based upon laparoscopic surgery but adds significant advantages to it. Two of these virtues – the three dimensional visualization and higher precision allow better control of blood vessels, thus reducing or eliminating blood loss.
Jehovah Witness patients in need of gynecologic surgery, including hysterectony, myomectomy, and excision of endometriosis benefit greatly from robotically assisted laparoscopic gynecologic surgery.