Robotic-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy—a retrospective matched control study

Comparison of Robotic, Laparoscopic and Abdominal Myomectomy in a Community Hospital

“…18 Comparison of outcomes for laparoscopic and roboticassisted laparoscopic myomectomy has demonstrated comparable clinical outcomes for blood loss, hospital stay, and complications despite longer robotic operative times in university hospitals and medical centers. 6,7 The American College of Obstetricians and Gynecologist and the American Association of Gynecologic Laparoscopist have confirmed the advantages of laparoscopy over laparotomy. Despite advances in laparoscopic technique, as well as the advantages of laparoscopic myomectomy reported over 30 y, most gynecologic procedures are still performed through abdominal incisions.…”

“…4,5 Comparison of outcomes for laparoscopic and robotic-assisted laparoscopic myomectomy (RALM) has demonstrated comparable clinical outcomes for blood loss, hospital stay, and complications despite longer robotic operative times. 6,7 The feasibility of the adoption of robotic-assisted surgery by the community gynecologist has been discussed by Payne et al 8 The authors concluded that the length of stay and decrease in blood loss seen with robotic-assisted surgery "hold true not only for academic centers but also in community settings involving Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, MD, USA (Drs Gobern, Rosemeyer); Women's Health Specialist, Holy Cross Hospital, Silver Spring, MD, USA (Drs Barter, Steren).…”

Robotic Surgery in Gynecology

“…abdominal myomektomiye göre daha hızlı toparlanma süreleri olsa da robotik myomektomide belirgin uzun operasyon süreleri ve yüksek maliyetle karşılaşılmaktadır. Bununla beraber, kan kaybı, hastanede kalış, ve komplikasyon oranları benzerdir (16,20). Konvansiyonel laparaskopik myomektomi ile karşılaştırıldığında ise daha az kan kaybı ve hastanede kalış süresi ile karşılaşılsa da, robotik myomektomide operasyon süresinin daha uzun olduğu bildirilmiştir (16).…”

“…Bununla beraber, kan kaybı, hastanede kalış, ve komplikasyon oranları benzerdir (16,20). Konvansiyonel laparaskopik myomektomi ile karşılaştırıldığında ise daha az kan kaybı ve hastanede kalış süresi ile karşılaşılsa da, robotik myomektomide operasyon süresinin daha uzun olduğu bildirilmiştir (16). Gebelik sonuçlarına bakacak olursak, pitter ve arkadaşları makalelerinde 107 hastanın 92'sinde doğum gerçekleştiğini bildirmiş sadece bir hastada uterin rüptür ile karşılaşılmıştır ve gebelik sonuçlarının abdominal myomektomiden farklı olmadığı bildirilmiştir (21).…”

The technique of robotic assisted laparoscopic surgery in gynaecology, its introduction

“…In Germany the use of the robotic system in gynaecological care is only at the beginning of a promising development. The spectrum of indications includes simple hysterectomies, above all in patients with uterine fibroids, with history of several previous abdominal operations, salpingoophorectomy in larger adnexal masses, interventions in extensive endometriosis, sacrocolpopexies, myomectomies (1,47,61), tubal reanastomosis and mainly the modified radical and radical hysterectomies (10, 20-22, 33, 41, 48, 49, 51, 53) in early stages of endometrial (16,25,26,28,31,32,36,37,50,(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69) and cervical cancer (12,42,65), especially nerve sparing radical hysterectomy, including pelvic and paraaortic, respectively upper paraaortic lymph node dissection, but also with less frequency trachelectomy, parametranectomy (3,11,14,52,54,55), interventions in early ovarian cancer (30,40), pelvic exenteration (15,35), colposuspension and the lateral colpopexy via transperitoneal approach (19,63,64), interventions in uterine malformations, and others (23). Many of these indic...…”