Robot-Assisted Laparoscopic Surgery in Gynecology: Scientific Dream or Reality?

Robotic-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy--a retrospective matched control study

OBJECTIVE

Compare robotic-assisted laparoscopic myomectomy (RALM) to a matched control standard laparoscopic myomectomy (LM).

DESIGN

A retrospective matched control study.

SETTING

Private practice setting.

PATIENT(S)

Premenopausal and postmenopausal women who underwent either robotic-assisted or standard laparoscopic myomectomy.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Retrospective chart review was performed. Cases of laparoscopic robotic-assisted myomectomies were compared with a matched control group of standard LM. Comparisons were based on Fisher's exact, Mann-Whitney, and exact chi-square tests.

RESULT(S)

Between January 2006 and August 2007, 15 consecutive RALMs were performed at our institution, compared with 35 matched control standard LMs. The two groups were matched by age, body mass index, parity, previous abdominopelvic surgery, size, number, and location of myomas. Mean surgical time for the RALM was 234 minutes (range 140-445) compared with 203 minutes (range 95-330) for standard LMs. Blood loss, hospitalization time, and postoperative complications were not significantly different.

CONCLUSION(S)

The RALM required a significant prolonged surgical time over LM. It appears that in the hands of a skilled laparoscopic surgeon, the RALM does not offer any major advantage. This technology, however, offers exciting potential applications while learning endoscopic surgery. Further studies are warranted to asses the utility of RALM for general gynecologic surgeons.