Robotic Single-Site Plus Two-Port Myomectomy versus Conventional Robotic Multi-Port Myomectomy: A Propensity Score Matching Analysis

Abstract

Background: Robotic single-site plus two port myomectomy (RSTM) was designed to reduce the number of incision sites while retaining the advantage of conventional robotic multi-port myomectomy (CRM). This study aimed to explicate RSTM and compare surgical outcomes between it and CRM. Methods: The medical records of 146 patients who had undergone RSTM and 173 who had undergone CRM were reviewed. The surgical outcomes between them were compared by propensity score matching (PSM) analysis. Results: The PSM analysis showed no statistically significant inter-group differences in patient characteristics. With regard to surgical outcomes, the RSTM group enjoyed shorter operative time (148.30 ± 44.8 vs. 162.3 ± 47.4 min, p = 0.011), less hemoglobin decrement (1.8 ± 0.9 vs. 2.3 ± 1.0 g/dL, p < 0.001), and shorter duration of hospital stay (5.4 ± 0.7 vs. 5.8 ± 0.7 days, p < 0.001). Conclusions: RSTM was associated with shorter operative time relative to CRM. Further prospective studies are needed in order to more fully investigate the advantages of RSTM.

Multi-Port Robotic-Assisted Laparoscopic Myomectomy: A Systematic Review and Meta-Analysis of Comparative Clinical and Fertility Outcomes

“…The initial pool of 955 studies, which resulted from the preliminary search of the medical databases, was refined via manual screening of the title and abstract, leading to 107 reports being moved to full-text assessment. Through constant evaluation and strict application of the pre-established inclusion criteria, 53 studies were ultimately included in this review [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. This systematic process of selection is summarised in Figure 1 .…”

Comparison of Multi- and Single-Site Robotic Myomectomy Using the Da Vinci® SP Surgical System: A Propensity Score Matching Analysis

“…Moreover, the visual analogue scale pain score was significantly lower in the RSSM group than in the RMSM group (2.4 ± 0.8 vs. 2.7 ± 0.8, p = 0.0149) [ 16 ]. Furthermore, Won et al reported that the RSSM group had a shorter operative time (148.3 ± 44.8 min vs. 162.3 ± 47.4 min, p = 0.011), lesser decrease in haemoglobin levels (1.8 ± 0.9 g/dL vs. 2.3 ± 1.0 g/dL, p < 0.001), and shorter duration of hospital stay (5.4 ± 0.7 days vs. 5.8 ± 0.7 days, p < 0.001) than the RMSM group [ 17 ]. In our study, the total operative time, docking time, console time, time to manual morcellation, and duration of hospital stay were significantly shorter in the RSSM group than in the RMSM group before 1:1 propensity score matching.…”

“…A recent systematic review and meta-analysis showed that pain score was significantly lower in the single-port laparoscopic myomectomy group, than in the conventional laparoscopic myomectomy group [ 23 ]. In addition, Ahn et al demonstrated that the post-operative pain score was significantly lower in RSSM than in RMSM (2.7 ± 0.8 vs. 2.4 ± 0.8, p = 0.0149) [ 17 ]. In our study, the duration of hospital stay in the RSSM group was significantly shorter than in the RMSM group (3.12 ± 0.77 days vs. 4.54 ± 1.48, p = 0.0001).…”

Surgical platforms and instruments in robotic hysterectomy using the da Vinci Xi system

“…Additionally, this technique is not ergonomically friendly. To overcome these constraints, a single-site plus additional port platform is a challenging and feasible procedure in gynecological surgery [27,28]. This modified platform reduces the number of incisions, while maintaining the advantages of conventional robotic hysterectomy.…”