Skip to main content
SpringerLink
Log in

Beyond the learning curve: improving outcomes in Robotic myomectomy compared to laparoscopic myomectomy

  • Original Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

Uterine myomas are benign tumours frequently seen in women of reproductive age. Myomectomy remains a viable option for treating this condition in women who wish to preserve their uterus. We undertook this study to compare the peri-operative surgical outcomes of Robotic myomectomy (RM) with laparoscopic myomectomy (LM) in Indian patients of uterine myomas after the initial learning curve of RM was achieved. A retrospective chart review was performed for the patients who underwent RM or LM for the treatment of uterine myomas. A total of 177 patients, 116 in the RM group and 61 in the LM group, were included in the study. The mean age in the RM and LM group was 34.31 ± 5.40 years and 33.54 ± 4.96 years, respectively (p = 0.355). The mean total operative time was marginally more in RM group (127.37 ± 110.67 vs. 120.66 ± 44.27, p = 0.650) but the difference was not statistically significant. Patients in the RM group had significantly less blood loss (115.43 ± 79.43 vs. 340.98 ± 453.9 ml, p = < 0.0001), hospital stay (1.28 ± 0.49 vs. 1.92 ± 1.05 days, p = < 0.0001), requirement of blood transfusion (93.97 vs. 81.97%, p = 0.031) and requirement of intravenous (IV) analgesia (41.38 vs. 34.43%, p = 0.019) as compared to the patients in the LM group. The Robotic myomectomy significantly reduces blood loss, the duration of hospital stay, and requirement of blood transfusions and IV analgesia as compared to the laparoscopic myomectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R (2017) Epidemiology of uterine fibroids: a systematic review. BJOG 124(10):1501–1512

    Article  CAS  PubMed  Google Scholar 

  2. Srilatha J, Malathi V (2017) Prevalence of fibroids: a study in a semiurban area in Telangana, India. Int J Reprod Contracept Obstet Gynecol 6(12):5247–5251

    Article  Google Scholar 

  3. Bartels CB, Cayton KC, Chuong FS et al (2016) An evidence-based approach to the medical management of fibroids: a systematic review. Clin Obstet Gynecol 59(1):30–52

    Article  PubMed  Google Scholar 

  4. David M, Pitz CM, Mihaylova A, Siedentopf F (2016) Myoma-associated pain frequency and intensity: a retrospective evaluation of 1548 myoma patients. Eur J Obstet Gynecol Reprod Biol 199:137–140

    Article  PubMed  Google Scholar 

  5. Donnez J, Dolmans MM (2016) Uterine fibroid management: from the present to the future. Hum Reprod Update 22(6):665–686

    Article  PubMed  PubMed Central  Google Scholar 

  6. Levy G, Hill MJ, Beall S, Zarek SM, Segars JH, Catherino WH (2012) Leiomyoma: genetics, assisted reproduction, pregnancy and therapeutic advances. J Assist Reprod Genet 29(8):703–712

    Article  PubMed  PubMed Central  Google Scholar 

  7. Shah S, Odejinmi JF, Agarwal N (2016) In laparoscopic myomectomy, does a caseload of 100 patients during the learning curve produce a significant improvement in performance measures? J Obstet Gynaecol India 66(Suppl 1):422–427

    Article  PubMed  Google Scholar 

  8. Sirkeci RF, Belli AM, Manyonda IT (2017) Treating symptomatic uterine fibroids with myomectomy: current practice and views of UK consultants. Gynecol Surg 14(1):11

    Article  PubMed  PubMed Central  Google Scholar 

  9. Semm K (1979) New methods of pelviscopy (gynecologic laparoscopy) for myomectomy, ovariectomy, tubectomy and adnectomy. Endoscopy 11(2):85–93

    Article  CAS  PubMed  Google Scholar 

  10. Kim MS, Kim WJ, Hyung WJ et al (2021) Comprehensive learning curve of robotic surgery: discovery from a multicenter prospective trial of robotic gastrectomy. Ann Surg 273(5):949–956

    Article  PubMed  Google Scholar 

  11. Senapati S, Advincula AP (2007) Surgical techniques: robot-assisted laparoscopic myomectomy with the da Vinci (®) surgical system. J Robot Surg 1(1):69–74

    Article  PubMed  PubMed Central  Google Scholar 

  12. Göçmen A, Şanlıkan F, Uçar MG (2013) Comparison of robotic-assisted laparoscopic myomectomy outcomes with laparoscopic myomectomy. Arch Gynecol Obstet 287(1):91–96

    Article  PubMed  Google Scholar 

  13. Barakat EE, Bedaiwy MA, Zimberg S, Nutter B, Nosseir M, Falcone T (2011) Robotic-assisted, laparoscopic and abdominal myomectomy: a comparison of surgical outcomes. Obstet Gynecol 117(2 Pt 1):256–266

    Article  PubMed  Google Scholar 

  14. Pluchino N, Litta P, Freschi L et al (2014) Comparison of the initial surgical experience with robotic and laparoscopic myomectomy. Int J Med Robot 10(2):208–212

    Article  PubMed  Google Scholar 

  15. Chen YC, Lin HH, Hsiao SM (2018) Comparison of robotic assisted laparoscopic myomectomy with barbed sutures and traditional laparoscopic myomectomy with barbed sutures. Taiwan J Obstet Gynecol 57(5):709–712

    Article  PubMed  Google Scholar 

  16. Geppert B, Lönnerfors C, Persson J (2011) Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery. Acta Obstet Gynecol Scand 90(11):1210–1217

    Article  PubMed  Google Scholar 

  17. Moss EL, Sarhanis P, Ind T, Smith M, Davies Q, Zecca M (2020) Impact of obesity on surgeon ergonomics in robotic and straight-stick laparoscopic surgery. J Minim Invasive Gynecol 27(5):1063–1069

    Article  PubMed  Google Scholar 

  18. Hsiao SM, Lin HH, Peng FS, Jen PJ, Hsiao CF, Tu FC (2013) Comparison of robot-assisted laparoscopic myomectomy and traditional laparoscopic myomectomy. J Obstet Gynaecol Res 39(5):1024–1029

    Article  PubMed  Google Scholar 

  19. Bedient CE, Magrina JF, Noble BN, Kho RM (2009) Comparison of robotic and laparoscopic myomectomy. Am J Obstet Gynecol 201(6):566.e1–5

    Article  PubMed  Google Scholar 

  20. Wang T, Tang H, Xie Z, Deng S (2018) Robotic-assisted vs. laparoscopic and abdominal myomectomy for treatment of uterine fibroids: a meta-analysis. Minim Invasive Ther Allied Technol 27(5):249–264

    Article  PubMed  Google Scholar 

  21. Qin L (2014) Comparison of Da Vinci’s robot and traditional laparoscopic myomectomy from uterine leiomyoma. Prog Obstetr Gynecol 23:903–904

    Google Scholar 

  22. Iavazzo C, Mamais I, Gkegkes ID (2016) Robotic assisted vs laparoscopic and/or open myomectomy: systematic review and meta-analysis of the clinical evidence. Arch Gynecol Obstet 294(1):5–17

    Article  PubMed  Google Scholar 

  23. Mangalath AS, Kumar L, Sawant AB, Kesavan R, Ravindran G, Sunil R (2021) Comparison of analgesic requirements in robot-assisted versus conventional laparoscopic abdominal surgeries. J Anaesthesiol Clin Pharmacol 37(1):79–84

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The financial grant for undertaking the study was provided by Intuitive Surgical India Pvt. Ltd.

Author information

Authors and Affiliations

  1. Department of Gynaecology, Laparoscopic and Robotic Surgery, Apollo Hospital, Hyderabad, Telangana, India

    Rooma Sinha

  2. Department of Gynaecology, Laparoscopic and Robotic Surgery, Apollo Hospital, Hyderabad, Telangana, India

    Bana Rupa

  3. Department of Gynaecology, Laparoscopic and Robotic Surgery, Apollo Hospital, Hyderabad, Telangana, India

    Mamatha Reddy

Authors
  1. Rooma Sinha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bana Rupa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mamatha Reddy
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RS contributed to the study conception and design. Material preparation, data collection and analysis were performed by RS, BR and MR. The first draft of the manuscript was written by RS, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Rooma Sinha.

Ethics declarations

Competing interests

The authors declare no competing interests.

Conflict of interest

The authors report no conflicts of interest in this work. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Authors declare they have no financial interests.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki and the applicable guidelines for good clinical practice (GCP). The approval was granted by the Institutional Ethics Committee—Biomedical Research of Apollo Hospitals, Hyderabad (Date: 26th April 2021/IEC Application No: AHJ-ACD-045/04–21).

Consent to participate

Being a retrospective data collection study, the study data were collected in an anonymised fashion. Hence, waiver of informed consent was applicable as per the regulatory guidelines.

Consent for publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sinha, R., Rupa, B. & Reddy, M. Beyond the learning curve: improving outcomes in Robotic myomectomy compared to laparoscopic myomectomy. J Robotic Surg 17, 847–852 (2023). https://doi.org/10.1007/s11701-022-01470-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-022-01470-1

Keywords

Search

Navigation