Robotic-Assisted Laparoscopic Myomectomy versus Traditional Laparoscopic Myomectomy: Are They the Same?

• Published in: Current obstetrics and gynecology reports Vol. 5; no. 4; pp. 341 - 347
• Main Authors: Nathan, Joseph H., Shvalb, Nir, Smorgick, Noam
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2016
• Subjects: Maternal and Child Health; Medicine; Medicine & Public Health; Minimally Invasive Gynecologic Surgery (S Puntambekar; Obstetrics/Perinatology/Midwifery; Oncology; Section Editor; Topical Collection on Minimally Invasive Gynecologic Surgery; Robotic-assisted myomectomy; Single site laparoscopy; Power morcellation; Laparoscopic myomectomy
• ISSN: 2161-3303; 2161-3303
• DOI: 10.1007/s13669-016-0182-y

The relative pros and cons of robotic-assisted laparoscopic myomectomy (RALM) and laparoscopic myomectomy (LM) are still debated. The short-term surgical outcomes such as estimated blood loss, need for blood transfusion, intra-operative complications, and conversion to laparotomy are similar for RALM and LM. Although RALM was previously thought to require longer operative time when compared to LM, recent studies show comparative surgical duration. On longer follow-up, high pregnancy rates and low pregnancy morbidity have been reported for both surgical approaches. The increased cost of RALM when compared to LM may be amortized in high-volume surgical centers. Specimen removal via power morcellation is limited by the FDA safety communication, but strategies for “contained” power and cold-knife morcellation may prevent unintentional fibroid spread. To conclude, RALM and LM are both safe minimally invasive alternatives to open abdominal myomectomy. Future technical developments may allow for the widespread implementation of single-site RALM and LM.