| publication name | Robotic-Assisted, Laparoscopic, and Abdominal Myomectomy: A Comparison of Surgical Outcomes |
|---|---|
| Authors | Ehab E. Barakat, MD , Mohamed A. Bedaiwy, MD , Stephen Zimberg, MD , Benjamin Nutter, Mohsen Nosseir, MD , and Tommaso Falcone, MD |
| year | 2011 |
| keywords | |
| journal | |
| volume | Not Available |
| issue | Not Available |
| pages | Not Available |
| publisher | Not Available |
| Local/International | International |
| Paper Link | Not Available |
| Full paper | download |
| Supplementary materials | Not Available |
Abstract
OBJECTIVE: To compare the surgical outcomes of robot- assisted laparoscopic myomectomy (robot-assisted), standard laparoscopic myomectomy (laparoscopic), and open myomectomy (abdominal). METHODS: Myomectomy patients were identified from the case records of the Cleveland Clinic and stratified into three groups. Operative and immediate postopera- tive outcomes were compared. Data analysis was per- formed using analysis of variance, Kruskal-Wallis analysis of ranks, 2 , and Fisher exact tests where appropriate. RESULTS: From a total of 575 myomectomies, 393 (68.3%) were abdominal, 93 (16.2%) were laparoscopic, and 89 (15.5%) were robot-assisted. The three groups were comparable regarding the size, number, and loca- tion of myomas after adjusting for body mass index. Significantly heavier myomas were removed in the robot- assisted group (223 [85.25, 391.50] g) compared with the standard group (96.65 [49.50, 227.25] g, P < .001) and were lower than in the abdominal group (263 [ 90.50, 449.00] g, P .002). Higher blood loss was reported in the abdomi- nal group compared with the other two groups, with a median (interquartile range) of blood loss in milliliters of 100 (50, 212.50), 200 (100, 437.50) and 150 (100, 200) in the laparoscopic, abdominal, and robot-assisted groups, respectively. The actual surgical time in minutes was 126 (95, 177) in the abdominal group, 155 (98, 200) in the laparoscopic group, and 181 (151, 265) in robot-assisted group ( P < .001). Patients in the abdominal group had a higher median length of hospital stay of 3 (2, 3) days, compared with 1 (0, 1) day in the standard group and 1 (1, 1) days in the robot-assisted group ( P < .001). CONCLUSION: Robotic-assisted myomectomy is asso- ciated with decreased blood loss and length of hospital stay compared with traditional laparoscopy and to open myomectomy. Robotic technology could improve the utilization of the laparoscopic approach for the surgical management of symptomatic myomas. (Obstet Gynecol 2011;117:1–1) DOI: 10.1097/AOG.0b013e318207854f LEVEL OF EVIDENCE: I