Postoperative Outcomes After Robotic Versus Abdominal Myomectomy

Griffin, Leanne; Feinglass, Joe; Garrett, Ariane; Henson, Anne; Cohen, Lionel; Chaudhari, A.; Lin, Alexander

doi:10.4293/108680813x13693422521557

Cited by 32 publications

(22 citation statements)

References 14 publications

(20 reference statements)

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“…Myomectomy is an accepted treatment for women with symptomatic myomas who wish to preserve fertility . Laparoscopic myomectomy (LM) is associated with less postoperative pain, blood loss, and shorter hospital stays, and it is more cosmetically acceptable (smaller scars) than abdominal myomectomy . LM is widely recognized for being less invasive, and prior studies have reported earlier recovery than abdominal myomectomy .…”

Section: Introductioncontrasting

confidence: 68%

“…As we rarely perform abdominal myomectomy, we cannot compare LM with laparotomy. However, LM is already known to be less invasive than laparotomy, therefore this comparison was not necessary in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic myomectomy (LM) is associated with less postoperative pain, blood loss, and shorter hospital stays, and it is more cosmetically acceptable (smaller scars) than abdominal myomectomy . LM is widely recognized for being less invasive, and prior studies have reported earlier recovery than abdominal myomectomy . However, only few studies have examined it quantitatively.…”

Section: Introductionmentioning

confidence: 99%

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Recovery of quality of life after laparoscopic myomectomy

Tsuzuki

Wada

et al. 2018

J of Obstet and Gynaecol

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Aim It is commonly thought that laparoscopic surgery leads to faster postoperative recovery for its low invasiveness. We evaluated postoperative quality of life (QOL) after laparoscopic myomectomy (LM) by using the Euro‐QOL 5 dimension (EQ‐5D) score and analyzed its relationship to surgical factors. Methods Between 2014 and 2016, 541 patients underwent LM at our institution. We included 86 patients in the final analysis (16% response rate) who replied to the EQ‐5D questionnaire, in order to investigate postoperative QOL. We evaluated patients’ EQ‐5D score before the operation and on the 3rd, 7th, 14th, 21st and 28th postoperative day (POD). We investigated the degree of correlation between the EQ‐5D score and four surgical characteristics (operation time, intraoperative bleeding, number of resected myomas and weight of specimen). We examined correlation between EQ‐5D scores and chief complaints such as hypermenorrhea, dysmenorrhea, other pain, myoma enlargement, palpable tumor and desire for childbearing. We also examined correlation between EQ‐5D scores and other factors such as patient's age, infertility, history of abdominal surgery, marriage and body mass index. Results Full recovery, defined as an EQ‐5D score of 1.0, was reported 2.3% of patients by POD3, 18.6% by POD7, 58.1% by POD14, 73.3% by POD21 and 86.0% by POD28. Longer duration of operation correlated weakly with poor recovery on POD3. Intraoperative bleeding, number of resected myomas and weight of the specimen did not significantly influence EQ‐5D score. There was no correlation between chief complaints or other factors mentioned above and EQ‐5D score. Conclusions More than a half of the patients undergoing LM included in our study reported full recovery of QOL after 2 weeks. The time to recover QOL was slightly influenced by the operation time. However, when LM was finished without any complications, postoperative QOL eventually seemed to improve regardless of the surgical characteristics such as operation time, intraoperative bleeding, number of resected myomas and weight of specimen.

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Section: Introductioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recovery of quality of life after laparoscopic myomectomy

Tsuzuki

Wada

et al. 2018

J of Obstet and Gynaecol

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“…These discrepancies may be related to differences in surgical approach. In comparison with laparoscopic surgery, open surgery is associated with higher postoperative wound pain levels and increased time until resumption of normal activities of daily life [28]. Some authors have suggested that higher postoperative wound pain levels and adhesion formation result in long-term impairment of quality of life after laparotomic procedures [29].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have suggested that higher postoperative wound pain levels and adhesion formation result in long-term impairment of quality of life after laparotomic procedures [29]. Griffin and colleagues observed lower postoperative wound pain levels and an accelerated return to work in women who underwent laparoscopic-robotic myomectomy compared with those who underwent myomectomy via laparotomy [28]. In addition to the clinical superiority of this surgical technique, our findings indicate that minimal-invasive myomectomy may also improve patient-reported outcomes relative to open myomectomy.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Quality of Life and Sexual Function in Premenopausal Women Undergoing Laparoscopic Myomectomy for Symptomatic Fibroids: A Prospective Observational Cohort Study

Radosa

Radosa²,

Mavrova

et al. 2016

PLoS ONE

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IntroductionUterine leiomyomas are the most common benign gynecologic tumors. To date laparoscopy myomectomy is the gold standard for treatment of symptomatic fibroids in reproductive-aged women. Detailed counseling about the effects of this procedure on postoperative sexuality and quality of life is important in these patients. However, available data on these subjects are limited and contradictory. The aim of this study was to assess sexual function and quality of life in premenopausal women undergoing laparoscopic myomectomy for symptomatic uterine fibroids.Material and MethodsAll premenopausal women who underwent laparoscopic myomectomy for symptomatic fibroids between April 2012 and August 2014 at a tertiary university center were enrolled in this prospective observational cohort study. Sexual function and quality of life were assessed for the pre- and postoperative (six months post-operatively) state using two validated questionnaires, the Female Sexual Function Index (FSFI) and the European Quality of Life Five-Dimension Scale (EQ-5D).ResultsNinety-five of the 115 (83%) eligible patients completed the study. Overall a significant improvement in quality of life and sexual function was observed in the study cohort: Median FSFI (28 (18.7–35.2)) and EQ-5D scores (1 (0.61–1) after laparoscopic myomectomy were significantly higher than preoperative scores (21.2 (5.2–33.5); 0.9 (0.2–1); p ≤ 0.01). The number, position and localization of the largest fibroids were not correlated with pre- or postoperative sexual function or quality of life.ConclusionLaparoscopic myomectomy might have positive short-term effects on postoperative quality of life and sexual function in premenopausal women suffering from symptomatic fibroids.

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Robotic‐assisted laparoscopic versus abdominal and laparoscopic myomectomy: A systematic review and meta‐analysis

Chen,

Ma,

Yang

et al. 2024

Intl J Gynecology & Obste

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BackgroundMyomectomy is the preferred treatment for women with uterine fibroids and fertility requirements. There are three modalities are used in clinical practice for myomectomy: abdominal myomectomy (AM), laparoscopic myomectomy (LM), and robot‐assisted laparoscopic myomectomy (RLM).ObjectivesTo compare the perioperative and postoperative outcomes of RLM, AM, and LM.Search StrategyWe searched PubMed, Web of Science, Embase, and Clinical Trials for relevant literature published between January 2000 and January 2023.Selection CriteriaWe included all studies reporting peri‐ and postoperative outcomes of myomectomy in patients with uterine myomas. Surgical treatments were classified as RLM, LM, or AM.Data Collection and AnalysisTwo or more authors selected studies independently, assessed risk of bias, and extracted data. We derived mean difference (MD) or odds ratio (OR) with 95% confidence intervals (CIs) for each outcome, subgrouping trials by the patient characteristics and myoma characteristics. We used the I2 statistic to quantify heterogeneity and the random‐effects model for meta‐analysis when appropriate. We used the funnel plot to assess the publication bias.Main ResultsA total of 32 studies with 6357 patients were included, of which 1982 women had undergone RLM. The operating time was significantly longer (MD = 43.58, 95% confidence interval [CI]: 25.22–61.93, P < 0.001), and the incidence of cesarean section after myomectomy was significantly lower (OR = 0.27, 95% CI: 0.10–0.78, P = 0.02) in RLM than in LM. Compared with AM, the operation time, blood loss, blood transfusion rate, complication rate, total cost, length of hospital stay, and pregnancy rate of patients with RLM were significantly different.ConclusionsThe safety and effectiveness of RLM are superior to those of AM but inferior to those of LM.

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Postoperative Outcomes After Robotic Versus Abdominal Myomectomy

Abstract: Operative time was significantly longer with robotic myomectomy; however, patients experienced shortened lengths of hospital stay and less time before returning to work.

Cited by 32 publications

References 14 publications

Recovery of quality of life after laparoscopic myomectomy

Recovery of quality of life after laparoscopic myomectomy

Postoperative Quality of Life and Sexual Function in Premenopausal Women Undergoing Laparoscopic Myomectomy for Symptomatic Fibroids: A Prospective Observational Cohort Study

Robotic‐assisted laparoscopic versus abdominal and laparoscopic myomectomy: A systematic review and meta‐analysis

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