Robotic-Assisted Paraurethral Myoma Excisions via Retropubic Space Dissection

Area of Science:

• Urology
• Minimally Invasive Surgery
• Gynecologic Oncology

Background:

• Paraurethral myomas are rare urethral masses, occurring in approximately 5% of urethral neoplasms.
• While often asymptomatic, they can cause urinary retention, vaginal bulge, and dyspareunia.
• Surgical excision is the standard treatment, typically approached vaginally or abdominally.

Purpose of the Study:

• To showcase robotic-assisted surgical treatment for a paraurethral myoma.
• To emphasize the dissection of the retropubic space during this procedure.
• To identify and highlight critical anatomical structures within the retropubic space.

Main Methods:

• Video demonstration of a robotic-assisted surgical excision of a symptomatic proximal paraurethral myoma.
• Detailed description of techniques for entering and dissecting the retropubic space.
• Identification of key anatomical borders and vasculature, including the pubic symphysis, bladder, urethra, pubocervical fascia, arcus tendinous fascia, dorsal vein of the clitoris, internal obturator vessels, and veins of Santorini.

Main Results:

• Successful robotic-assisted retropubic space dissection for paraurethral myoma excision.
• Clear visualization and identification of critical anatomical structures during the procedure.
• Demonstration of safe surgical technique for myoma removal.

Conclusions:

• Robotic-assisted retropubic space dissection offers a safe and effective approach for paraurethral myoma excision.
• This technique allows for precise identification of vital anatomical structures, minimizing risks.
• The video serves as a valuable educational resource for surgeons performing this procedure.