Robotic-assisted laparoscopic myomectomy: the feasibility in single-site system
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ObjectiveTo evaluate the feasibility of robotic single-site myomectomy (RSSM). MethodsMedical records of 355 consecutive women who underwent robotic-assisted laparoscopic myomectomy wereretrospectively reviewed. Clinical characteristics were compared between multi-site and single-site systems. After 1:1propensity score matching for the total myoma number, largest myoma size, and total tumor weight (105 women ineach group), surgical outcomes were also compared between the 2 systems. ResultsA total of 105 (29.6%) and 250 (70.4%) women underwent RSSM and robotic multi-site myomectomy (RMSM),respectively. RSSM was more commonly performed in women with lower body mass index (21.6 vs. 22.5 kg/m2,P=0.014), without peritoneal adhesions (7.6% vs. 24.8%, P<0.001), and less (2.6 vs. 4.6, P<0.001) and smaller (6.3 vs. 7.7 cm, P<0.001) myomas compared to RMSM. After propensity score matching, the largest myoma size (P=0.143),total myoma number (P=0.671), and tumor weight (P=0.510) were not significantly different between the 2 groups. Although the docking time was significantly longer in the RSSM group (5.1 vs. 3.8 minutes, P=0.005), total operationtime was similar between RSSM and RMSM groups (145.9 vs. 147.3 minutes, P=0.856). Additionally, hemoglobindecrement was lower in the RSSM group than in the RMSM group (1.4 vs. 1.8 g/dL, P=0.009). No surgical complicationwas observed after RSSM, while 1 ileus and 2 febrile complications occurred in women that underwent RMSM (0% vs. 2.9%, P=0.246). ConclusionAlthough RMSM is preferred for women with multiple large myomas in real clinical practice, RSSM seems to be afeasible surgical method for less complicated cases, and is associated with minimal surgical morbidity.
Abstract
ObjectiveTo evaluate the feasibility of robotic single-site myomectomy (RSSM). MethodsMedical records of 355 consecutive women who underwent robotic-assisted laparoscopic myomectomy wereretrospectively reviewed. Clinical characteristics were compared between multi-site and single-site systems. After 1:1propensity score matching for the total myoma number, largest myoma size, and total tumor weight (105 women ineach group), surgical outcomes were also compared between the 2 systems. ResultsA total of 105 (29.6%) and 250 (70.4%) women underwent RSSM and robotic multi-site myomectomy (RMSM),respectively. RSSM was more commonly performed in women with lower body mass index (21.6 vs. 22.5 kg/m2,P=0.014), without peritoneal adhesions (7.6% vs. 24.8%, P<0.001), and less (2.6 vs. 4.6, P<0.001) and smaller (6.3 vs. 7.7 cm, P<0.001) myomas compared to RMSM. After propensity score matching, the largest myoma size (P=0.143),total myoma number (P=0.671), and tumor weight (P=0.510) were not significantly different between the 2 groups. Although the docking time was significantly longer in the RSSM group (5.1 vs. 3.8 minutes, P=0.005), total operationtime was similar between RSSM and RMSM groups (145.9 vs. 147.3 minutes, P=0.856). Additionally, hemoglobindecrement was lower in the RSSM group than in the RMSM group (1.4 vs. 1.8 g/dL, P=0.009). No surgical complicationwas observed after RSSM, while 1 ileus and 2 febrile complications occurred in women that underwent RMSM (0% vs. 2.9%, P=0.246). ConclusionAlthough RMSM is preferred for women with multiple large myomas in real clinical practice, RSSM seems to be afeasible surgical method for less complicated cases, and is associated with minimal surgical morbidity.
참고문헌 (20)
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