Comparison of operative time between robotic and laparoscopic myomectomy for removal of numerous myomas

Abstract

Background: We hypothesized that the total operative time of robot myomectomy (RM) is shorter than that of laparoscopic myomectomy (LM) in cases where numerous myomas are removed, due to the faster suturing time of the robotic system. To verify this, we compared the surgical outcomes of RM vs LM for the number of myomas removed. Methods: The medical records of 144 women underwent LM and 121 women underwent RM by a single surgeon were reviewed. Results: The operative time did not statistically differ between the groups, even when the number of removed myomas was more than 12 (200.6 ± 48.2 vs 196.0 ± 48.4 minutes, P = .791). Note that in our logistic regression analysis, the operation type was excluded from the independent risk factors prolonging operative time. Conclusion: RM showed a similar operative time relative to LM regardless of the number of myomas removed (numerous or not).

Efficacy and safety of robot-assisted laparoscopic myomectomy versus laparoscopic myomectomy: a systematic evaluation and meta-analysis

“…A total of 1219 articles were obtained, and after eliminating duplicates by Endnote X9, and then eliminating irrelevant papers by reading the title and abstract, 15 articles were retained after reading the full text [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. See Table 1 for basic information on the selected literature.…”

“…15,[17][18][19][20][21][22] with a total of 1937 patients, 941 patients in the RALM group and 996 patients in the LM group.There was statistical heterogeneity between studies (P<0.00001, I 2 =94%), so a random effects model was used for data analysis. The results [MD=38.61, 95%CI (19.36, 57.86), P<0.0001] indicate a statistically signi cant difference between the two surgical approaches in terms of operative time, suggesting that the LM group had a shorter operative time than the RALM group, the results of the Meta-analysis are shown in Figure2.Comparison of intraoperative bleedingA total of 11 studies [8-10,12-15,17-18,[21][22] were included with a total of 1367 patients, 648 patients in the RALM group and 719 patients in the LM group.Comparison of length of stay in hospitalA total of 10 studies were included[9][10][12][13][14][15]17,[20][21][22] with a total of 1425 patients, 669 patients in the RALM group and 756 patients in the LM group. There was statistical heterogeneity between studies (P=0.54, I 2 =0%), so a xed effects model was used for data analysis.…”

Current status on robotic assisted myomectomy

“…The consensus is that multiport myomectomy is preferred for larger myomas, while single-site is feasible for selected patients with less complicated cases, and both methods are associated with low rates of intra-and post-operative complications [15,16] . In a very recent review, no significant differences were found in operating time, blood loss, and total complication rate [17] .…”

Robotic surgery in gynecology - myomectomy

“…Gargiulo et al [19] likewise reported a longer operative time in RM than in LM (195.1 vs. 118.3 minutes, P<0.001). On the other hand, other studies found that operative times were similar [3,18,22]. A meta-analysis including 15 studies concluded that there were no significant RM-versus-LM differences in surgical outcomes including operative time, estimated blood loss, transfusion rate, length of hospital stay or complication rate [16].…”

“…Also, a docking procedure which is to move robot to patient and attach all arms to the patient is necessary, which makes surgery longer. In our previous study, mean docking time was 2.4±1.6 minutes [3]. Currently, the robotic platform is widely utilized in many major gynecologic surgeries including hysterectomy, oophorectomy, myomectomy, ovarian cystectomy, and sacrocolpopexy [1].…”