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Robotic Myomectomy

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Robotic-Assisted Minimally Invasive Surgery

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Abstract

Despite irrefutable evidence of the superiority of minimally invasive myomectomy over open abdominal myomectomy, laparoscopic myomectomy has an unacceptably low adoption in most countries. Robotic myomectomy is a proven solution to this unsustainable status quo. Introduced in 2004, this operation has a long safety record, allows the performance of a truly microsurgical operation, and can be applied to most clinical scenarios, thereby limiting the need for open myomectomy.

This chapter separates the myomectomy operation in its fundamental components and critically analyzes the impact of robotic technology on each one. It also provides a practical checklist for the robotic surgeon so that every element is optimized for success. Preoperative imaging, pharmacological preparation, port placement, and technical details are covered in detail, as are more challenging scenarios including very large myomas, retroperitoneal myomas, and surgical options for minimal cosmetic impact. Basic aspects of contained tissue extraction are also reviewed.

As robotic surgical platforms continue to evolve, and will soon proliferate beyond the current general expectations of the medical community, this chapter aims to provide a current general strategy for robotic myomectomy that is likely to remain relevant for the users of future generations of surgical robots.

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Author information

Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Antonio R. Gargiulo

  2. Center for Robotic Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Antonio R. Gargiulo

  3. Exeter Hospital, Exeter, NH, USA

    Antonio R. Gargiulo

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  1. Antonio R. Gargiulo
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Correspondence to Antonio R. Gargiulo .

Editor information

Editors and Affiliations

  1. School of Medicine, Department of Surgery, University of Nevada, Las Vegas, NV, USA

    Shawn Tsuda

  2. Department of General Surgery, Tufts University School of Medicine, Boston, MA, USA

    Omar Yusef Kudsi

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Gargiulo, A.R. (2019). Robotic Myomectomy. In: Tsuda, S., Kudsi, O. (eds) Robotic-Assisted Minimally Invasive Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-96866-7_26

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  • DOI: https://doi.org/10.1007/978-3-319-96866-7_26

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