7989 Cannonball Fibroid Robotic Myomectomy with Specimen Extraction Using Excite Technique

Pessoa, P.D.; Romano, J.J.; Ramos, Gonçalo; Maranhao, D.D.A.; Gomes, Mariano Tamura Vieira; Barison, G.A.

doi:10.1016/j.jmig.2022.09.359

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“…In another study by Pessoa et al [ 23 ], the ExCITE technique was used for the extraction of a large fibroid (14.2 cm) from the abdominal cavity in the context of laparoscopic myomectomy: the specimen was efficiently extracted, providing aesthetic benefits for the patient. She was discharged on the second-day post-surgery without any complications.…”

Section: Discussionmentioning

confidence: 99%

C-section technique vs minilaparotomy after minimally invasive uterine surgery: a retrospective cohort study

Della Corte,

Guarino,

Vitale

et al. 2023

Arch Gynecol Obstet

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Purpose Uterine leiomyomas are benign uterine tumors. The choice of surgical treatment is guided by patient's age, desire to preserve fertility or avoid "radical" surgical interventions such as hysterectomy. In laparotomy, the issue of extracting the fibroid from the cavity does not arise. However, in laparoscopy and robotic surgery, this becomes a challenge. The aim of the present study was to determine the optimal surgical approach for fibroid extraction following laparoscopic or robotic myomectomy in terms of postoperative pain, extraction time, overall surgical time, scar size, and patient satisfaction. Methods A total of 51 patients met the inclusion criteria and were considered in our analysis: 33 patients who had undergone the "ExCITE technique" (Group A), and 18 patients a minilaparotomy procedure (Group B), after either simple myomectomy, multiple myomectomy, supracervical hysterectomy, or total hysterectomy. The diagnosis of myoma was histologically confirmed in all cases. Results Regarding the postoperative pain evaluation, at 6 h, patients reported 4 [3–4] vs 6 [5.3–7] on the VAS in Group A and B, as well as at 12 h, 2 [0–2] vs 3.5 [2.3–4] in Group A and B, respectively: both differences were statistically significant (p < 0.001). No statistically significant difference at 24 h from surgery was found. All patients in Group A were satisfied with the ExCITE technique, while in Group B only 67% of them. The length of the hospital stay was significantly shorter in Group A as compared to Group B (p = 0.007). In terms of the operative time for the extraction of the surgical specimen, overall operative time, and the scar size after the surgery, there was a statistically significant difference for those in Group A. Conclusion The ExCITE technique does not require specific training and allows the surgeon to offer a minimally invasive surgical option for patients, with also an aesthetic result. It is a safe and standardized approach that ensures tissue extraction without the need for mechanical morcellation.

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Section: Discussionmentioning

confidence: 99%