Robotic-assisted laparoscopic complex myomectomy: A single medical center's experience

Objective: Conventional laparoscopic myomectomy (LM) has inherent limitations due to its rigid structure. The robotic system is a newly developed technology equipped with a flexible EndoWrist that offers good performance in delicate motions. Our objective was to share our clinical experience in the management of complex myomectomy using this robotic system. Materials and methods: From October 2010 to March 2012, 21 patients with symptomatic complex uterine myomas were evaluated. Complex myomectomy was defined as surgery involving more than two fibroids, large fibroids, or preexisting pelvic adhesions. We recorded and analyzed the preoperative characteristics of the patients and the fibroids, the detailed surgical time, and several postoperative outcomes to evaluate the feasibility and efficacy of robotic-assisted LM (RALM) for complex fibroids. Results: A total of 21 patients were enrolled in this study. The mean age of the patients was 40.1 +/- 4.5 years and the mean size of the largest fibroid was 7.3 +/- 3.5 cm. RALM achieved satisfactory results, including a short postoperative hospital stay (3.1 +/- 0.9 days), a low conversion rate (none of our patients required conversion to either a minilaparotomy or conventional open surgery), and a low complication rate (1 case in 21 patients, 4.8%). The average estimated blood loss was 235.7 +/- 2833 mL. Conclusion: Our study results demonstrated that RALM is a safe and effective method for handling complex fibroids. Copyright (C) 2014, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.