Robot-assisted single-incision laparoscopic myomectomy: initial report and technique

Single-incision laparoscopic surgery for gynecologic applications has recently been described. Such an ultra-minimally invasive technique is attractive to patients and may have clinical advantages because of the reduced number of abdominal incisions. However, because of its extreme geometrical challenges and instrument crowding, single-incision laparoscopy is such a major deviation from optimum surgical ergonomics that it is unlikely to gain popularity. Robot assistance in single-incision laparoscopy has recently been described for some ablative gynecologic procedures, and it seems to have technical advantages. However, no suture-intensive applications of this technique have yet been reported. We describe our initial experience with robot-assisted single-incision laparoscopic myomectomy and provide essential technical detail to enable successful replication of this technique in the context of an advanced robotic surgical team.