Robotic single site myomectomy Initial report and technique

Capsule:
Robotic single-site myomectomy is a safe and reproducible reproductive surgery technique. We report our initial experience with an original step-by-step protocol using novel wristed instrumentation.

Authors:
Erin I. Lewis, M.D., Serene S. Srouji, M.D., Antonio R. Gargiulo, M.D.

Volume 103, Issue 5, Pages 1370-1377

Abstract:

Objective:
To report the first cases of robotic single-site (RSS) myomectomy with the use of the Da Vinci Si Surgical System with wristed semirigid instrumentation.

Design:
Case series.

Setting:
University hospital.

Patient(s):
Four patients with symptomatic uterine fibroids desiring conservative minimally invasive surgical treatment.

Intervention(s):
Four RSS myomectomies were performed with the Da Vinci Single-Site platform. Data regarding patient characteristics, indication of surgery, and perioperative outcomes were collected.

Main Outcome Measure(s):
Safety and reproducibility of RSS myomectomy.

Result(s):
All RSS procedures were completed successfully. Median operative time was 210 minutes (range 202–254 min). Median blood loss was 103 mL (range 75–200 mL). No instrument failures were noted during the procedures. No operative or major postoperative complications occurred. Two patients were discharged on the day of surgery, and two were discharged after overnight observation.

Conclusion(s):
RSS myomectomy with the use of wristed semi-rigid instrumentation is a feasible procedure. Indications, safety, and use of the technique will be confirmed by growing experience.

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