Robotic-assisted gynae surgery gains ground: Does it deliver beyond the hype?

A Sydney hospital continues to break new ground, becoming one of the first public hospitals in Australia to offer robotic-assisted gynaecological surgery – further cementing its reputation as a surgical innovator. The Nepean Hospital was also the first public facility in New South Wales to introduce the da Vinci robotic system, setting a precedent in the state’s public health sector.

“In the public sector, it’s a very new thing to perform gynaecological surgery robotically. We’re only the second or third hospital in Australia doing it,” said Dr Naman Dahiya, Gynaecologist at Nepean Hospital.

“Complex surgeries [including hysterectomies or treating endometriosis] often involve bowel resections or urology procedures at the same time, and the benefits of robotic surgery are significantly greater than traditional laparoscopic surgery – for both the surgeon and the patient.”

The ergonomic advantages of robotic surgery are also noteworthy. Surgeons benefit from a seated operating position, reduced fatigue, and enhanced precision – all of which contribute to long-term surgical sustainability.

“The ports don’t move as much, so patients get less pain at the incisions,” Dr Dahiya explained. “We can also operate at lower gas pressures inside the abdomen, which means less pain afterwards. We’ve noticed that patients having big surgeries, including bowel resections, often go home the next day. For some hysterectomies, they’re even going home the same day.”

As uptake increases in gynaecology, the broader value of robot-assisted laparoscopic surgery compared to conventional laparoscopy remains a point of clinical discussion.

Among all surgical disciplines, robotic technology demonstrates the clearest advantage in radical prostatectomy for prostate cancer. Compared to conventional laparoscopy, robotic-assisted prostatectomy is associated with reduced intraoperative blood loss and superior outcomes in postoperative sexual function and urinary continence.

However, a recent review suggests the benefits of robotic-assisted surgery in gynaecology are less conclusive. Evidence regarding quality of life, functional outcomes, and cost-effectiveness remains mixed, with studies producing inconsistent findings and no clear consensus.

Dr Caroline Ruth Mathias, a final-year RANZCOG fellow who completed her surgical training at Nepean Hospital, stated “If robotic surgery isn’t already the present, it’s definitely the future – and Nepean has really led the way in bringing it into the public sector.”

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