Comparing Two Types of Robotic Single-Site Myomectomy Using Propensity Score Matching: Coaxial with da Vinci Xi vs....

Area of Science:

• Minimally Invasive Surgery
• Gynecologic Oncology
• Robotic Surgery

Background:

• Uterine fibroids (myomas) are common, often requiring surgical intervention.
• Robotic surgery offers advanced capabilities for complex gynecologic procedures.
• Comparing different robotic platforms is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare surgical outcomes of coaxial robotic single-site myomectomy (RSSM) using da Vinci Xi versus da Vinci SP systems.
• To evaluate differences in blood loss, operative time, and recovery between the two robotic platforms.

Main Methods:

• Retrospective review of 81 women undergoing coaxial RSSM (da Vinci Xi) and 108 women undergoing myomectomy (da Vinci SP).
• Propensity score matching based on myoma characteristics (count, size, FIGO type).
• Comparison of patient demographics and surgical outcomes, including blood loss, operative time, hemoglobin change, and hospital stay.

Main Results:

• The coaxial RSSM group exhibited significantly lower estimated blood loss (p < 0.001) and shorter operative time (p < 0.001) compared to the SP group.
• Hemoglobin decrement was significantly smaller in the coaxial RSSM group (p < 0.001).
• Hospital stay was shorter in the SP group (p < 0.001), with no significant differences in postoperative complications.

Conclusions:

• Coaxial RSSM using the da Vinci Xi system is associated with reduced operative time and blood loss compared to myomectomy with the da Vinci SP system.
• While the da Vinci SP system demonstrated a shorter hospital stay, further investigation is needed.
• Prospective studies are warranted to definitively compare the surgical outcomes of these two robotic myomectomy techniques.