Robotic Myomectomy: Five Modifications in Our Practice

Sinha, Rooma; Rupa, Bana

doi:10.1007/s13224-021-01553-3

Cited by 2 publications

(4 citation statements)

References 8 publications

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“…Both the numbers and the sizes of the fibroids were lower in the group of patients undergoing minimally invasive myomectomy compared to the fibroids of patients undergoing abdominal myomectomy. Strengthening this observation, our results indicated a statistically significant higher number of myomas in the laparotomic group across 10 studies [20,24,26,35,[38][39][40][41][42]44]. This aspect is among the most crucial, as the sizes of myomas can influence extraction decisions.…”

Section: Comments On Datasupporting

confidence: 69%

“…The hospital stay duration was also assessed, with six studies showing a significantly lower duration for the minimally invasive approach [20,24,26,[42][43][44]. This aligns with the existing literature, emphasizing one of the primary advantages of endoscopy, which is a reduction in the length of the hospital stay.…”

Section: Comments On Datamentioning

confidence: 56%

“…Regarding The estimated blood loss was documented in our review, revealing significant differences between the two groups in nine studies [20,24,26,35,36,39,[42][43][44]. Specifically, the estimated blood loss in patients undergoing abdominal myomectomy averaged 378.33 mL, whereas in those undergoing the minimally invasive procedure, it averaged 217.4 mL.…”

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confidence: 81%

“…This surgical technique proves especially beneficial in complex cases. Robotic-assisted myomectomy is selected in situations where the advantages of robotic technology can elevate the surgical procedure, including intricate cases with large or numerous fibroids, challenging-to-reach locations, instances involving significant scar tissue or adhesions from prior surgeries, and for patients desiring fertility preservation [20].…”

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confidence: 99%

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Exploring Surgical Strategies for Uterine Fibroid Treatment: A Comprehensive Review of Literature on Open and Minimally Invasive Approaches

Cianci,

Gulino,

Palmara

et al. 2023

Medicina

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Background and Objectives: Uterine myomas represent one of the most prevalent pathologies affecting the female population. These benign neoplasms originate from the smooth muscular cells of the uterus, and they can be either single or multiple. Often associated with debilitating symptoms such as pelvic heaviness, pain, constipation, and urinary dysfunctions, the surgical management of myomectomy exhibits considerable variability. This diversity in approaches is influenced by factors such as the number and size of myomas, the patient’s age, and overall clinical conditions. This study aims to elucidate and compare the advantages and disadvantages of different surgical approaches, specifically endoscopic procedures versus open surgery, providing valuable insights for clinical decision making. Materials and Methods: A comprehensive bibliographic search spanning from 2013 to 2023 was systematically conducted across databases including Medline, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov. The search utilized keywords such as “myomectomy laparoscopic and open”, “myomectomy open and minimally invasive”, “myomectomy open and laparoscopic”, and “myomectomy open vs. laparoscopic.” The research methodology, along with predetermined inclusion and exclusion criteria, was established prior to the search, ensuring a systematic and rigorous approach. Subsequently, data analysis was carried out. Results: Following the study selection process, 25 articles met the eligibility criteria for inclusion in this analysis. The average numbers of myomas were 3.7 (ranging from 1 to 13.7) and 5.4 (ranging from 1 to 13.5) for the minimally invasive surgery and open surgery groups, respectively. In terms of myoma size, the total averages across studies were 7 cm (ranging from 4.8 to 14) for the minimally invasive group and 8 cm (ranging from 3.9 to 11.2) for the open surgery group. The average pregnancy and delivery rates were 29.7% (ranging from 1.8 to 100) for the minimally invasive group and 28.5% (ranging from 1.8 to 100) for the open surgery group. Regarding complications, the average rate was 14.2% (ranging from 0 to 50) for the endoscopic group and 22.3% (ranging from 0 to 60.3) for the laparotomic group. Conclusions: In conclusion, a critical factor influencing the choice of surgical approach is primarily the size and quantity of fibroids. The mini-laparotomic approach emerges as a viable alternative to endoscopy, demonstrating favorable surgical outcomes and aesthetic results. Interestingly, the type of surgical procedure appears to have no significant impact on the pregnancy rate.

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