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Updated: Mar 21, 2026
Robotic Enucleation of Esophageal Leiomyoma
Published on: February 20, 2026
Coaxial robot-assisted laparoendoscopic single-site myomectomy
Antonio R Gargiulo1, Souzana Choussein2, Serene S Srouji2
1Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., ASB1-3, Boston, MA, 02115, USA. agargiulo@partners.org.
Robot-assisted laparoendoscopic single-site (RA-LESS) myomectomy using standard rigid instruments is safe and effective for selected patients. This minimally invasive technique offers excellent cosmetic and postoperative outcomes, warranting further investigation for broader application.
Area of Science:
- Minimally Invasive Gynecologic Surgery
- Robotic Surgery
- Urogynecology
Background:
- Uterine fibroids (myomas) are common, often causing significant symptoms like menorrhagia and pelvic pressure.
- Traditional myomectomy can involve extensive incisions and longer recovery times.
- Minimally invasive approaches, including laparoendoscopic single-site surgery (LESS), aim to reduce morbidity and improve cosmetic outcomes.
Purpose of the Study:
- To describe the technique and evaluate the outcomes of coaxial robot-assisted laparoendoscopic single-site (RA-LESS) myomectomy.
- To assess the safety, reproducibility, and effectiveness of RA-LESS myomectomy in a cohort of 21 patients.
Main Methods:
- Retrospective cohort study of 21 patients undergoing RA-LESS myomectomy between October 2011 and November 2013.
- Utilized the da Vinci Si Surgical System with standard rigid 8 or 5 mm instrumentation in a coaxial arrangement through a single LESS port.
- Data collected included patient demographics, presenting symptoms, tumor characteristics, operative time, blood loss, and hospital stay.
Main Results:
- The mean age of patients was 38.1 years, with a mean BMI of 29.4 kg/m².
- The mean largest tumor diameter was 5.7 cm, with an average of 2.2 tumors removed per surgery.
- Mean operative time was 154.2 minutes, mean blood loss was 57.9 cc, and median hospital stay was 0 days. All procedures were completed successfully without conversion to other surgical approaches.
Conclusions:
- Coaxial RA-LESS myomectomy using standard rigid instrumentation is a safe and reproducible minimally invasive surgical option.
- The technique provides excellent cosmetic and postoperative outcomes in selected patients with uterine fibroids.
- Further research is needed to identify specific patient populations that would benefit most from this RA-LESS approach.
