Variables that prolong total operative time for robotic-assisted laparoscopic myomectomy: A 10-year tertiary hospital study in Korea

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 262; pp. 62 - 67
• Main Authors: Park, Kyung-Min, Kang, SoYeon, Kim, Chaewon, Sung, Yeji, Chung, Youn-Jee, Song, JaeYen, Kim, Sukil, Kim, Mee-Ran
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.07.2021
• Subjects: Operative time; Robotic surgical procedures; Uterine myomectomy; Robotic surgical procedures; Uterine myomectomy; Operative time
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2021.05.003

•The total operative time (TOT) of robotic-assisted laparoscopoic myomectomy is related to the number, total weight of myomas and the location of dominant myoma.•Among the preoperative factors, the number of myomas is the most important factor affecting TOT.•Da Vinci Xi is associated with shorter TOT than da Vinci S robotic system.•The console time of robotic surgery is not associated with the type of robotic system and the location of dominant myoma. To identify factors that prolong total operative time (TOT) in robotic-assisted laparoscopic myomectomy (RALM). Retrospective cohort study. Tertiary university hospital. Women who underwent RALM between April 2009 and May 2019 conducted by a single high-volume gynecologic surgeon. Patients’ demographic data and intraoperative records were obtained. The association between the perioperative characteristics and TOT was analyzed. A total of 584 cases met the inclusion criteria, with a mean TOT of 231.6 ± 86.7 min. The mean patient age was 36.3 ± 5.5 years, and the patients had a mean of 4.2 ± 4.0 myomas. The dominant myoma had a mean diameter of 7.6 ± 2.6 cm. The mean total weight of the extracted myomas removed was 202.2 ± 152.6 g. From multiple regression analysis, the following perioperative factors were intimately associated with the TOT: ① body mass index, ② the number of myomas, ③ weight of total myomas, ④ location of dominant myoma, ⑤ type of da Vinci robot system, ⑥ endometrial cavity opening during the operation, ⑦ intraoperative blood loss, and ⑧ patient hospitalization period. The number of myoma was most closely related to the TOT, with an R2 value of 0.330. All of the above factors with the exception of the type of robot system and location of dominant myoma were related to the console time. Age, parity, history of previous abdominal surgery, surgical indication, diameter, and FIGO classification were not associated with the TOT. With an accurate identification of the perioperative parameters above, we can improve the quality of RALM by counselling, selecting an appropriate patient selection, and preoperative planning.