Hybrid Robotic Single-Site Myomectomy Using the GelPoint Platform

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Surgical Innovation
• Urogynecology

Background:

• Single-port laparoscopic myomectomy (SP-LM) and robotic single-site myomectomy (RSSM) have limitations.
• A novel hybrid approach, H-RSSM, integrates advantages of both SP-LM and RSSM.
• This technique aims to improve outcomes for patients with symptomatic uterine fibroids.

Purpose of the Study:

• To describe the surgical technique of hybrid robotic single-site myomectomy (H-RSSM).
• To report initial clinical experiences and outcomes of H-RSSM.
• To compare H-RSSM with previous myomectomy techniques (SP-LM and SPLA-TUM).

Main Methods:

• H-RSSM was performed on 25 women with symptomatic fibroids between February 2018 and September 2018.
• Fibroid enucleation utilized single-port laparoscopy.
• Uterine defect repair was performed using robotic single-site surgery.
• Outcomes were compared to historical data from SP-LM and single-port laparoscopically assisted transumbilical ultraminilaparotomic myomectomy (SPLA-TUM).

Main Results:

• Mean operative time was 69.4 minutes, with a mean hemoglobin change of 1.2 g/dL.
• Mean return of bowel activity was 37.1 hours, and mean hospital stay was 4.0 days.
• H-RSSM demonstrated significantly shorter operation times and faster return of bowel activity compared to SP-LM and SPLA-TUM, with no conversions to laparotomy or multiport procedures.

Conclusions:

• Hybrid robotic single-site myomectomy (H-RSSM) is a feasible surgical alternative for selected patients with symptomatic fibroids.
• The technique shows potential for reducing operating time and conversion rates.
• Further research is necessary to definitively establish the benefits of H-RSSM.