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A systematic review and meta-analysis comparing robotic single-site versus multi-port myomectomy

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Abstract

The objective of this study was to compare the surgical outcomes of robotic multi-site myomectomy (RMSM) with those of robotic single-site myomectomy (RSSM). We conducted a systematic search of the PubMed, CINAHL, Scopus, and Google Scholar databases for articles comparing RMSM and RSSM until March 2023. Data analysis was performed using Review Manager V5.3 (Cochrane), and the main outcomes examined were perioperative outcomes and complications. A total of five studies, covering 823 patients, were included in the analysis. The statistical analysis revealed no significant differences between RMSM and RSSM with regard to docking time (p = 0.9), console time (p = 0.37), estimated blood loss (p = 0.38), postoperative hemoglobin (Hb) loss (p = 0.61), transfusion rate (p = 0.25), length of stay (p = 0.08), conversion (p = 0.36), postoperative fever (p = 0.46), intraoperative complication (p = 0.23), or postoperative complication (p = 0.12). However, compared to RMSM, RSSM was found to have a shorter morcellation time (weighted mean difference [WMD] − 4.52 min; 95% confidence interval [CI] − 6.89 to 2.15; p = 0.0002), less total operative time (WMD − 9.83 min; 95% CI − 18.27 to − 1.38; p = 0.02), lower Hb change (WMD − 0.28 g/dL; 95% CI − 0.49 to − 0.07; p = 0.008), and fewer overall complications (odds ratio [OR] 0.55; 95% CI 0.32–0.92; p = 0.02). Our findings suggest that RSSM is a safe and effective alternative to RMSM for the most studied outcomes. Further randomized studies are necessary to validate these results.

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Author notes

  1. Li Wang and Jing-ya Deng have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China

    Li Wang & Ping-yu Zhu

  2. Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China

    Jing-ya Deng

  3. Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730030, China

    Kun-peng Li

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  1. Li Wang
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  2. Jing-ya Deng
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  3. Kun-peng Li
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  4. Ping-yu Zhu
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Contributions

WL: protocol development, methodology. KP and JY: data collection and management. WL: writing original draft, and visualization. PY: study supervision.

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Correspondence to Ping-yu Zhu.

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Wang, L., Deng, Jy., Li, Kp. et al. A systematic review and meta-analysis comparing robotic single-site versus multi-port myomectomy. J Robotic Surg 17, 1319–1328 (2023). https://doi.org/10.1007/s11701-023-01597-9

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  • DOI: https://doi.org/10.1007/s11701-023-01597-9

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