Senior Consultant, Gynaecological Surgical Oncology, BLK-Max Super Speciality Hospital, New Delhi
Part 4 of 12 in Role of Minimally Invasive Surgeries in Gynaecologic Oncology
When Robotic Surgery Is the Right Call for Benign Gynaecological Disease
August 27, 2026
Not every benign gynaecological case needs a robotic approach, but Dr. Alka Dahiya has identified a specific set of cases where the technology's precision changes the outcome.
Complex hysterectomy
Patients with a history of previous LSCS or previous laparotomies, where severe adhesions are anticipated, are cases where standard laparoscopy carries higher risk. Dr. Dahiya reaches for the robotic system specifically when she is anticipating this kind of complexity going in.
Severe endometriosis
This is where Dr. Dahiya finds the technology most outstanding. When pelvic planes are obliterated by disease, the magnified vision and precision of the robotic system allow complete excision of endometriotic tissue, including deposits outside the ovary and fallopian tubes, in a way she considers difficult to match with standard laparoscopy.
Ovarian cystectomy, tubal reversal and reconstructive procedures
Studies cited in the masterclass show that robotic cystectomy preserves ovarian tissue and AMH values better than laparoscopic cystectomy, an outcome that matters directly to a patient's future fertility. Tubal reversal, vaginoplasty, cerclage and prolapse repair round out the list of benign procedures where Dr. Dahiya finds robotics readily applicable, largely because of the fine suturing and reconstruction these procedures demand.
Still a matter of judgement
None of this amounts to a blanket policy. Dr. Dahiya is direct on this point: candidates are chosen carefully, case by case, rather than defaulted into a robotic approach because the option exists.
This guide is based on a live Jivo Masterclass — Dr. Alka Dahiya taught doctors across Africa on March 29, 2026.
FROM THE LIVE Q&A
Dr. Katuga
For someone coming from a general medicine background in gynaecology rather than a surgical one, what is the process for training in robotic surgery in India?
Dr. Alka Dahiya
A basic surgical background is required. Admission into a robotic training course in India requires an MS in Obstetrics & Gynaecology or MS in General Surgery, with at minimum some exposure to procedures such as LSCS, so the surgeon understands the underlying operative anatomy and principles. Without that foundation, the transition is very difficult. Requirements vary by country, and it would be worth checking what pathways exist locally.
Frequently Asked Questions
How long does it take to train to become competent in robotic surgery, what does that training cost, and is it necessary to train in laparoscopy first?▼
It is definitely possible to train in robotics directly, and many surgeons find it easier to learn than laparoscopic surgery, especially if they are already comfortable with open surgery. India has a three-step pathway supported by Intuitive: Level 1 is simulation-based certification, Level 2 requires 30 to 50 procedures completed independently or under supervision, and Level 3 is advanced training. There is no requirement to learn laparoscopy first, though prior exposure helps. Most surgeons gain confidence within a year of focused training, with a trained bedside assistant supporting the docking and undocking process.
Is it possible to visit your centre for training, or to join a fellowship there?▼
Yes. BLK-Max takes two robotic fellows every year, one in surgical oncology and one specifically in gynaecologic oncology, each for a one-year fellowship in minimally invasive robotic surgical oncology. The full application procedure and selection criteria would be shared afterward through the Jivo Healthcare team.
What is the average cost of a robotic surgery, for example a robotic hysterectomy for endometriosis?▼
Cost depends on the exact procedure. For endometriosis surgery, whether it involves removing the uterus or only a cystectomy changes the figure, but in Indian currency the cost is typically 4 to 5 lakhs, roughly 4,000 to 5,000 US dollars.
For someone coming from a general medicine background in gynaecology rather than a surgical one, what is the process for training in robotic surgery in India?▼
A basic surgical background is required. Admission into a robotic training course in India requires an MS in Obstetrics & Gynaecology or MS in General Surgery, with at minimum some exposure to procedures such as LSCS, so the surgeon understands the underlying operative anatomy and principles. Without that foundation, the transition is very difficult. Requirements vary by country, and it would be worth checking what pathways exist locally.
Which benign gynaecological conditions benefit most from robotic surgery?▼
Complex hysterectomy in patients with prior LSCS or laparotomies where severe adhesions are anticipated, severe endometriosis with obliterated pelvic planes, and ovarian cystectomy are the cases where the technology's precision changes the outcome most.
How does robotic cystectomy affect a patient's future fertility compared with laparoscopic cystectomy?▼
Studies show robotic cystectomy preserves ovarian tissue and AMH values better than laparoscopic cystectomy, an outcome that matters directly to a patient's future fertility.
What other reconstructive procedures can be performed robotically?▼
Tubal reversal, vaginoplasty, cerclage and prolapse repair round out the benign procedures where robotics is readily applicable, largely because of the fine suturing and reconstruction these procedures demand.
Is robotic surgery automatically the default choice for benign cases when it is available?▼
No. Candidates are chosen carefully, case by case, rather than defaulted into a robotic approach simply because the option exists.
In This Series: Role of Minimally Invasive Surgeries in Gynaecologic Oncology
- 1.Robotic Surgery in Gynaecologic Oncology
- 2.The Da Vinci System: Why It Outperforms Laparoscopy in Gynaecologic Oncology
- 3.Patient Positioning and Why Manipulators Are Left Out of Cancer Cases
- 4.When Robotic Surgery Is the Right Call for Benign Gynaecological Disease
- 5.Choosing Cancer Patients for Robotic Surgery: The Rules That Cannot Bend
- 6.The Operating Room Rules That Don't Change With the Platform
- 7.ICG-Guided Sentinel Lymph Node Dissection: Sparing a Full Pelvic Clearance
- 8.Four Cases: How Robotic Surgery Changed the Surgical Outcome
- 9.The Data Behind the Claims: 331 Patients Across Two BLK-Max Studies
- 10.What Robotic Surgery Still Costs, in Money and in Time
- 11.Becoming a Robotic Gynaecologic Oncology Surgeon: The Training Path
- 12.What Comes Next: Da Vinci 5, AI and the Single Port