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Chang, Kim, Kim, Kim, Cho, Cho, Chay, Kim, Kim, Lee, and Seo: The feasibility of robot-assisted laparoscopic myomectomy: Compared with standard laparoscopic and abdominal myomectomy
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(12): 784-793.

Published online: 15 December 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.12.784

The feasibility of robot-assisted laparoscopic myomectomy: Compared with standard laparoscopic and abdominal myomectomy

Min Young Chang, MD1, Sun Young Kim, MD1, Min-A Kim, MD1, Bo Wook Kim, MD1, Hanbyoul Cho, MD1, SiHyun Cho, MD1, Doo Byung Chay, MD2, Jae Hoon Kim, MD1, Young Tae Kim, MD3, Byung Seok Lee, MD1, Kyung Seo, MD1

1Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

2Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

3Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Jae Hoon Kim, MD. Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Gangnam-gu, Seoul 135-720, Korea. Tel: +82-2-2019-3436, Fax: +82-2-3462-8209, jaehoonkim@yuhs.ac

Received 31 May 2011       Revised 2 September 2011       Accepted 11 October 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

To compare robotic myomectomy to laparoscopic and open myomectomy.

Methods

We retrospectively analyzed medical records of patients undergoing myomectomy between January 2007 and March 2011. Patients were stratified into three groups by surgical approach. Clinical features and surgical outcomes were compared.

Results

From a total of 206 myomectomies, 31 (15%) were robotic, 70 (34%) were laparoscopic, and 105 (51%) were open. Heavier myomas were removed in the robotic group (164.3 ± 193.7 g) than in the laparoscopic (117.3 ± 132.7 g) group but were lighter than the myomas removed in the open group (284.7 ± 265.6 g) (P = 0.002; open vs. laparoscopic). Greater blood loss was reported in the open and robotic groups than in the laparoscopic group with a mean blood loss of 456.6 ± 288.5 mL, 380.6 ± 303.8 mL, and 198.5 ± 137.6 mL, respectively (P < 0.001; open vs. laparoscopic, P = 0.004; robot vs. laparoscopic). Actual surgical time was 272.5 ± 116.8 minutes in the robotic, 172.1 ± 49.4 minutes in the laparoscopic (P < 0.001; robot vs. laparoscopic), and 152.3 ± 45.3 minutes in the open group (P < 0.001; robot vs. open). Patients in the robotic group had shorter mean length of hospital stay of 4.1 ± 1.4 days as compared to 5.5 ± 1.3 days in the open (P < 0.001; robot vs. open) but there were no significant differences between the robotic and laparoscopic groups (3.8 ± 1.0 days).

Conclusion

Laparoscopic group is associated with decreased blood loss but significantly smaller myomas when compared with the other two groups. However, robotic myomectomy does not fall behind open myomectomy in terms of myoma size or surgical outcomes. In conclusion, robotic myomectomy can replace the role of open myomectomy.

Keywords: Robotic surgery, Laparoscopic surgery, Myomectomy

Figures and Tables

Fig. 1
Box plot comparing the uterine size (A), weight of the removed myomas (B), and hospital stay (C) by the surgical approach.
kjog-54-784-g001
Table 1
Patients characteristics
kjog-54-784-i001

BMI, body mass index; Gweeks, gestational weeks; Preop. GnRH agonist inj., preoperative gonadotropin releasing hormone agonist injection.

Table 2
Radiologic and pathologic characteristics of the myoma
kjog-54-784-i002
Table 3
Surgical factors and outcomes of the different surgical approaches
kjog-54-784-i003
Table 4
Intraoperative and postoperative complication
kjog-54-784-i004

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