Comparison of robotic assisted laparoscopic myomectomy with barbed sutures and traditional laparoscopic myomectomy with barbed sutures

Objective: To elucidate whether robotic assisted laparoscopic myomectomy (RALM) with barbed sutures is superior to traditional laparoscopic myomectomy (TLM) with barbed sutures. Material and methods: Medical records of all women with symptomatic uterine myomas who underwent RALM with barbed sutures or TLM with barbed sutures were reviewed. The patients were allocated into the two groups based on their financial considerations. Results: Between July 2012 and March 2016, 78 patients underwent TLM (n = 52) or RALM (n = 26). Younger age, low parity, larger diameter of myoma and weight of removed myoma, and low incidence of prior histories of cesarean section were found in the RALM group, compared with TLM. An increase of surgical time (coefficient = 51.9 min, P < 0.001), length of hospital stay (coefficient = 0.47 days, P = 0.04) and duration of abdominal drain placement (coefficient = 0.53 days, P = 0.04) were found in the RALM group, compared with TLM. Nonetheless, there was no statistical difference in postoperative day 1 abdominal drainage between the RALM and TLM groups (median 95 mL vs. 110 mL, P = 0.21). Conclusion: Despite longer surgical time of RALM, RALM with barbed sutures did not show a significant decrease in postoperative abdominal drainage, compared with TLM with barbed sutures; and this hints that the use of barbed suture in TLM might diminish the superiority of RALM about the decrease of postoperative blood loss. Thus, TLM with barbed sutures remains a good alternative for laparoscopic myomectomy in the era of robot. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.