The Largest Uterine Leiomyoma Removed by Robotic-Assisted Laparoscopy in the Late Reproductive Age: A Case Report

Jeong, Hye Gyeong; Lee, Min Jung; Lee, Jung Ryeol; Jee, Byung Chul; Kim, Seul Ki

doi:10.6118/jmm.20028

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Several case studies show the enucleation of huge myomas (the biggest being 28 cm and 3.2 kg), while pushing the limits of robotic assisted techniques [25,26] . These cases confirm the efficiency, reliability, and safety of the robotic approach in well-selected cases regardless of the size of the fibroids.…”

Section: Large/heavy/multiple Myomasmentioning

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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Section: Large/heavy/multiple Myomasmentioning

confidence: 99%

Current status on robotic assisted myomectomy

Kiss¹,

Svobodová²,

Karasek³

et al. 2021

MIS

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“…Robot-assisted laparoscopic myomectomy (RALM) has been suggested as an effective surgical method, with comparable surgical outcomes to laparoscopic myomectomy [ 8 ]. Our group previously reported that RALM could be successfully performed in a patient with a myoma as large as 28 cm [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical and Fertility Outcomes of Reduced-Port Robotic Myomectomy: A Single-Center Experience of 401 Cases

Paik,

Hong,

Choi

et al. 2024

JCM

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Background: Reduced-port robotic myomectomy (RPRM) using Da Vinci® Xi™ is a good fertility-saving surgical option, but the surgical and fertility outcomes are unknown. Methods: This was a retrospective cohort study evaluating the feasibility of RPRM in an academic tertiary hospital setting. A total of 401 patients who underwent RPRM by a single operator between October 2017 and October 2021 were included. For RPRM, three ports are required: a 1.5 cm umbilical incision and two 0.8 cm incisions 8 cm lateral to the umbilicus. A single-port system was applied through the umbilicus, which also functioned as a working port. Unlike conventional robotic surgery, only three robot arms were utilized for the entire surgical procedure. Results: Surgical and fertility outcomes were assessed through medical records review and follow-up telephone contact. The mean age of patients at the time of surgery was 39.7 ± 6.0 years. The most common indication for surgery was menorrhagia (n = 128, 31.9%). The average number of myomas removed was 4.7 ± 4.1 (1–22), and the size was 7.8 ± 2.5 cm (2.5–16.0). The mean operation time was 103.7 ± 45.6 min. Postoperative complications were found in 9.7% (n = 39) of patients; the most common complication was transfusion (7.7%, n = 31). After surgery, 70 patients tried to conceive, and 56 became pregnant naturally or by assisted reproduction (56/70, 80.0%). The mean interval time from operation to conception was 13.5 ± 10.1 months. Among 56 who conceived, 44 gave birth (62.9%), five were still ongoing (7.1%), and seven had miscarriages (10.0%). Cesarean section was performed for most cases (43/44, 97.7%). Eight patients had obstetric complications (16.3%), but no uterine rupture was reported. Conclusions: RPRM, which provides the benefits of conventional robotic surgery along with favorable obstetric and cosmetic results, is a feasible option for patients with symptomatic uterine myomas who wish to conceive in the future.

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“…With great deal of interest we read the article entitled: “The Largest Uterine Leiomyoma Removed by Robotic-Assisted Laparoscopy in the Late Reproductive Age: A Case Report” by Jeong et al [ 1 ].…”

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confidence: 99%

Minimal Invasive Myomectomy with Morcellation for Giant Myoma: A Challenge or a Questionable Approach?

Iavazzo

Gkegkes²

2021

J Menopausal Med

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This study aimed to discuss the possible role of morcellation for a giant myoma in the minimal invasive approach. Current literature, including U.S. Food and Drug Administration guidelines, was reviewed. We found that safety of morcellation for a giant myoma is questionable. The risk and benefits of morcellation as well as alternative treatment options should be discussed with each individual patient.

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The Largest Uterine Leiomyoma Removed by Robotic-Assisted Laparoscopy in the Late Reproductive Age: A Case Report

Cited by 5 publications

References 13 publications

Current status on robotic assisted myomectomy

Current status on robotic assisted myomectomy

Surgical and Fertility Outcomes of Reduced-Port Robotic Myomectomy: A Single-Center Experience of 401 Cases

Minimal Invasive Myomectomy with Morcellation for Giant Myoma: A Challenge or a Questionable Approach?

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