Robot-Assisted Myomectomy for Large Uterine Myomas: A Single Center Experience

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Uterine myomas are common, often requiring surgical intervention.
• Large myomas present surgical challenges, potentially increasing risks.
• Robot-assisted myomectomy (RAM) is an evolving surgical technique.

Purpose of the Study:

• To assess the feasibility of robot-assisted myomectomy (RAM) for large uterine myomas (≥9cm).
• To compare surgical outcomes between patients with large myomas and those with smaller myomas.

Main Methods:

• Retrospective review of 207 robot-assisted myomectomy cases performed by a single surgeon.
• Patients were categorized into two groups: largest myoma ≥9cm and <9cm, matched for age and time.
• Key outcomes analyzed included operative time and estimated blood loss (EBL).

Main Results:

• The group with large myomas (≥9cm) experienced significantly longer operative times (130 min vs. 92 min) and higher EBL (100 mL vs. 25 mL).
• No major adverse outcomes were observed in patients with the largest myomas (≥15cm) or high specimen weights (>900gm).
• All patients in the study cohort, regardless of myoma size, were discharged on the same day post-surgery.

Conclusions:

• Robot-assisted myomectomy (RAM) is a feasible surgical option for women with large uterine myomas (≥9cm).
• Patients undergoing RAM for large myomas are suitable for same-day discharge, indicating a favorable safety profile.