GENERAL GYNECOLOGY Comparison of robotic-assisted laparoscopic myomectomy outcomes with laparoscopic myomectomy Ahmet Go ¨c ¸men • Fatih S ¸ anlıkan • Mustafa Gazi Uc ¸ar Received: 25 July 2011 / Accepted: 14 August 2012 / Published online: 30 August 2012 Ó Springer-Verlag 2012 Abstract Purpose This study aimed at comparing short-term out- comes of patients who underwent robotic-assisted laparo- scopic myomectomy and laparoscopic myomectomy. Methods From January 2008 to August 2010, prospective data including 15 consecutive patients who underwent robotic-assisted myomectomy (RALM) with the da Vinci surgical system were recorded. These cases were compared with a retrospective cohort of 23 patients who underwent laparoscopic myomectomy (LM). Patient demographics, fibroid characteristics and peri-operative data (operative time, anesthesia time, set-up time, console time for robotic cohort, Estimated blood loss (EBL), length of hospital stay, conversion to laparotomy and operative complications were collected in both groups. Results Mean operative time for the robotic group was 138.73 ± 39.51 min compared with 140.57 ± 38.17 min for the laparoscopy group (p = 0.887). No significant dif- ferences were noted between RALM versus LM for hos- pital stay (1.67 ± 0.58 vs. 1.87 ± 0.67 days, p = 0.369) and EBL (101.33 ± 39.84 vs. 119.78 ± 43.70 ml, p = 0.549). The numbers, size and location of myomas removed for two groups were similar. None of the cases in both groups required conversion to laparotomy. There were no signifi- cant intra-operative and post-operative complications in either group. Conclusion RALM appears to provide the same surgical outcomes when compared with traditional laparoscopic myomectomy. Keywords Robotic-assisted laparoscopic myomectomy Á Laparoscopic myomectomy Introduction Myomectomy refers to the surgical removal of uterine leiomyomas, also known as fibroids. Fibroids are the most commonly seen benign tumors in reproductive women. In contrast to a hysterectomy, the uterus remains preserved and the woman retains her reproductive potential after myomectomy. The surgical techniques for removal of leiomyomas include laparotomy, laparoscopy, hysteros- copy and recently robotic technique. The laparoscopic myomectomy offers minimal post operative discomfort, a shorter hospital stay, and rapid convalescence when com- paring with open myomectomy [1]. Laparoscopic myo- mectomy has been considered as a minimally invasive alternative to traditional open abdominal myomectomy due to reduced intra-abdominal formation of adhesions [2]. Moreover, the reduced adhesion formation following lap- aroscopy is another benefit for fertility of the patients. Laparoscopic myomectomy is currently a challenging operation that requires a very well-trained surgical team, adequate instrumentation and can only be offered to well- selected patients. Laparoscopy requires advanced laparo- scopic skills to maneuver rigid laparoscopic instruments that are fixed at the skin level by trocars, resulting in an overall reduction in degrees of freedom for dissection and suturing as compared with open surgery. Unfortunately, laparoscopic suturing is still a very difficult and time- consuming task. This can be overcome by robotic-assisted surgery. The use of a remotely controlled robot has potential to facilitate laparoscopic suturing by allowing the surgeon to be seated comfortably, scale the surgeon’s A. Go ¨c ¸men (&) Á F. S ¸ anlıkan Á M. G. Uc ¸ar Department of Obstetrics and Gynecology, U ¨ mraniye Education and Research Hospital, Adem Yavuz Cad. No 1, Kadın Hastalıkları ve Dog ˘um Klinig ˘i, U ¨ mraniye, Istanbul, Turkey e-mail: gocmenahmet@yahoo.com 123 Arch Gynecol Obstet (2013) 287:91–96 DOI 10.1007/s00404-012-2530-0