Technique for Tissue Containment and Extraction in the Complex Minimally Invasive Myomectomy Setting

Moawad, Gaby; Tyan, Paul; Awad, Charbel

doi:10.1016/j.jmig.2018.10.007

Cited by 10 publications

(8 citation statements)

References 4 publications

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“…First, with RSTM, omitting the morcellation process is possible for small myomas, which is to say that, thanks to the 23-mm diameter of the umbilical trocar, myomas of smaller diameter can be extracted directly, and quickly and simply, even in the docking state. In cases of multiple myomas, myomas have to be strung together with every single enucleation so as not to lose a myoma prior to initiation of morcellation [ 10 ]. However, again, for small myomas of less than 23-mm diameter, no such time-consuming stringing procedure is necessary.…”

Section: Discussionmentioning

confidence: 99%

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

Won

Choi

Lee

et al. 2022

JPM

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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.

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Section: Discussionmentioning

confidence: 99%

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

Won

Choi

Lee

et al. 2022

JPM

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“…With advances in surgical techniques and devices, the use of minimally invasive surgery at present encompasses extraction of even large specimens; however, extraction of specimens from giant myoma and adenomyosis poses a major challenge [1,2]. In minimally invasive gynecologic surgery, extraction of large specimens is commonly performed with or without manual or electromechanical morcellation, either through the trocar wound with an extended incision, an additional abdominal wound, or the vaginal canal [3].…”

Section: Abstract: Morcellation; Laparoscopy; Hysterectomymentioning

confidence: 99%

Technique for transvaginal removal of large specimen using an Alexis Contained Extraction System during laparoscopic hysterectomy

et al. 2022

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Transvaginal removal of large specimens during laparoscopic hysterectomy can be a complex surgical procedure that poses a risk of organ injury and tissue spillage into the abdominal cavity and is associated with extraction of the specimen and manual morcellation. Our objective was to demonstrate a technique for transvaginal removal of large specimens using the Alexis Contained Extraction System (CES) in laparoscopic hysterectomy. MethodsThe technique used for transvaginal removal of large specimens using the Alexis CES was presented in this video. Surgery was performed at a tertiary hospital. ResultsFollowing resection of the specimen during laparoscopic hysterectomy, the Alexis CES was inserted into the abdominal cavity through the umbilical trocar wound. The specimen was placed in a bag to prevent

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“…Considering the better flexibility of robotic instruments, enucleation of small myomas should be more accessible, leading to lower recurrence. Another reason for higher recurrence was found to be associated with the preoperative use of GnRH agonists therapy to decrease the size of myomas [38] .…”

Section: Fertility and Obstetrical Outcomes And Recurrencementioning

confidence: 99%

Current status on robotic assisted myomectomy

Kiss¹,

Svobodová²,

Karasek³

et al. 2021

MIS

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Uterine leiomyomas are common benign solid tumors of the uterus. While the presence of fibroids is rarely life threatening, they are associated with symptoms affecting quality of life and fertility. Myomectomy is a standard fertility-sparing surgery which should be considered for women suffering from fibroid-related symptoms who do not desire hysterectomy or any alternative treatment option. While open surgery is thought to be reserved for large and numerous myomas, mini-invasive methods as laparoscopy and robot-assisted surgery have evolved in the hands of experienced surgeons to also deal with these more complex cases. Robotic myomectomy has its advantages in lower blood loss, fewer complications, and shorter hospital stay over open surgery, whereas the comparison outcomes with laparoscopic myomectomy are still uncertain. Advantages of the wristed instruments, three-dimensional vision along with the incorporation of correct surgical techniques could emphasize the benefits of the robotic assisted approach in large and numerous myoma cases. Careful and detailed assessment should precede the surgery to recognize risks and steps to reduce operation time, which tends to be the most presented drawback of robotic myomectomy. As the tendency of robot-assisted surgeries is growing, many authors share their experience or publish comparison studies with other surgical methods. Our article describes the current status concerning robotic myomectomy, reviewing publications from the past five years (2016-2021).

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Technique for Tissue Containment and Extraction in the Complex Minimally Invasive Myomectomy Setting

Cited by 10 publications

References 4 publications

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

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

Technique for transvaginal removal of large specimen using an Alexis Contained Extraction System during laparoscopic hysterectomy

Current status on robotic assisted myomectomy

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