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Postoperative Complications in Laparoscopic versus Robotic Myomectomy: A Systematic Review and Meta-analysis
Gabriella Ferreira Marucci da Silva1, Lorena Burim Bernardo da Silva1, Maria Luísa de Andrade Reis1
1Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Avenida Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Robotic myomectomy offers reduced blood loss and fewer conversions to laparotomy compared to laparoscopic myomectomy for symptomatic uterine fibroids. Both surgical techniques are safe, aiding clinical decisions.
Area of Science:
- Gynecology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Uterine leiomyomas (fibroids) are common, often symptomatic, and myomectomy is a standard treatment.
- Robotic and laparoscopic approaches are increasingly used for myomectomy, but direct comparisons of postoperative outcomes are essential.
Purpose of the Study:
- To compare postoperative complications between robotic and laparoscopic myomectomy for symptomatic uterine leiomyomas.
- To provide evidence to guide clinical decision-making in surgical treatment of fibroids.
Main Methods:
- A systematic review and meta-analysis of studies comparing robotic and laparoscopic myomectomy.
- Searches were conducted in PubMed, EMBASE, and Scopus, including randomized controlled trials and observational studies.
- Nineteen studies involving 2,510 patients were included.
Main Results:
- Robotic myomectomy was associated with significantly less blood loss (MD 36.35 mL) and lower conversion rates to laparotomy (RR 0.46) compared to laparoscopy.
- No significant differences were found in hemoglobin drop, transfusion rates, overall postoperative complications, or postoperative fever.
- A total of 1,366 patients underwent laparoscopic myomectomy and 1,144 underwent robotic myomectomy.
Conclusions:
- Robotic myomectomy shows advantages in reduced blood loss and lower laparotomy conversion rates.
- Both robotic and laparoscopic myomectomy are safe procedures for symptomatic uterine leiomyomas.
- Findings support informed surgical choices based on patient factors and available resources.