Robotic myomectomy for large uterine myomas

Objective: To evaluate surgical outcomes and feasibility of robotic myomectomy in large uterine myomas. Materials and methods: This is a retrospective study for robotic myomectomies performed from October 2012 to August 2017 by a single surgeon in a tertiary care referral hospital. Demographics, diagnosis, perioperative variables, operative outcomes and complications were recorded. Large uterine myoma was defined as the estimated diameter of dominant myoma equal to or larger than 10 cm by sonography. Results: Seventy-four patients were included and 32 (43.2%) patients had large uterine myoma. Patients with myoma larger than 10 cm showed significantly heavier myoma weight (446.5 +/- 206.2 mg vs. 288.1 +/- 147.5, p < 0.001), similar blood loss (309.4 +/- 190.3 mL vs. 200.9 +/- 285.9 mL, p = 0.06), and longer operative time (263.4 +/- 83.7 min vs. 219.1 +/- 75.7 min, p = 0.02) compared with patients with myoma <10 cm. The largest myoma removed was 20 cm in diameter. Perioperative complications were rare. Conclusion: Robotic myomectomy is feasible for managing large uterine myomas. It is a safe procedure with acceptable longer operative time. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.