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Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection

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Total Robotic Myomectomy in a Complex Case: Extending the Limits.

Pakhee Aggarwal¹, Suneeta Mittal¹, Deepika Hooda¹

¹Department of Obstetrics and Gynaecology, Fortis Memorial Research Institute, Gurugram, Haryana, India.

Gynecology and Minimally Invasive Therapy

|October 26, 2020

Summary

This study details a successful robotic myomectomy for a patient with extensive uterine fibroids and endometriosis, demonstrating the procedure

Keywords:

Large myomas morbid obesity multiple myomas total robotic myomectomy

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Published on: January 3, 2020

Area of Science:

Reproductive Medicine
Minimally Invasive Surgery
Gynecologic Oncology

Background:

Uterine fibroids (myomas) are common benign tumors that can cause infertility and other symptoms.
Robotic myomectomy offers potential advantages over traditional laparotomy for complex cases.
Obesity and endometriosis can complicate fibroid surgery.

Observation:

A 30-year-old female with primary infertility and multiple large uterine fibroids (up to 22-week size) underwent robotic surgery.
The patient had a high body mass index (42 kg/m²) and concurrent endometriosis.
Four large fibroids, totaling 750g, were removed robotically with morcellation.

Findings:

Total robotic myomectomy and endometriosis clearance were successfully performed.
The procedure had a console time of 160 minutes with minimal blood loss (0.1 g/dL hemoglobin drop).
The patient experienced an uneventful recovery.

Implications:

Robotic myomectomy can be safely extended beyond current recommendations for fibroid number and surgical time.
This approach may offer a viable option for complex fibroid cases in patients with obesity and endometriosis.
Successful robotic myomectomy can improve fertility outcomes in selected patients.