Feasibility of Reduced-Port Robotic Surgery for Myomectomy with the da Vinci Surgical System

To present our initial experience with reduced-port robotic surgery (RPRS) for myomectomy using the Octo-Port system (DalimSurgNet, Seoul, Korea).

Prospective and noncomparative study (Canadian Task Force classification II-3).

University hospital.

Nineteen consecutive patients with symptomatic uterine myomas desiring conservative minimally invasive robotic surgery from October 2015 to December 2016.

An 8.5-mm or 12-mm robotic camera cannula was inserted through 1 of the Octo-Port channels and an 8-mm conventional robotic port was inserted into a 10-mm channel of the Octo-Port through a 3-cm transumbilical incision. An additional 8-mm conventional robotic port was inserted into a typical robotic port site in the patient's right abdomen.

Feasibility and operative outcomes of RPRS myomectomy. The median docking time and console time were 10 minutes (range, 4-22) and 90 minutes (range, 29-198). The largest myoma was located on the anterior uterine wall in 11 patients (57.9%). The median myoma size and weight were 7.2 cm (range, 4.1-10.5) and 141 g (range, 42-590), respectively. Median operative blood loss and change in hemoglobin were 100 mL (range, 30-700) and 2.6 mg/dL (range, .1-3.8), respectively. The procedure was successfully performed via RPRS in 89.5% of patients; 2 patients required placement of 1 to 2 additional robotic ports, resulting in a return to traditional multiport robotic surgery. There were no major postoperative complications or postoperative hernias.

Our experience demonstrated the feasibility of RPRS for myomectomy using the Octo-Port system in selected patients.