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Robotic single-site versus multi-port myomectomy: a case-control study

Authors
 So Hyun Ahn  ;  Joo Hyun Park  ;  Hye Rim Kim  ;  SiHyun Cho  ;  Myeongjee Lee  ;  Seok Kyo Seo  ;  Young Sik Choi  ;  Byung Seok Lee 
Citation
 BMC SURGERY, Vol.21(1) : 264, 2021-05 
Journal Title
BMC SURGERY
Issue Date
2021-05
MeSH
Aged, 80 and over ; Case-Control Studies ; Female ; Humans ; Laparoscopy* ; Leiomyoma* / surgery ; Operative Time ; Pregnancy ; Reproducibility of Results ; Retrospective Studies ; Robotic Surgical Procedures* ; Uterine Myomectomy* / adverse effects ; Uterine Neoplasms* / surgery
Keywords
Comparative study ; Minimally invasive surgery ; Robot myomectomy ; Robotic multi-port myomectomy ; Robotic single-site myomectomy
Abstract
Background: This study aimed to evaluate the compatibility of robotic single-site (RSS) myomectomy in comparison with the conventional robotic multi-port (RMP) myomectomy to achieve successful surgical outcomes with reliability and reproducibility.

Methods: This retrospective case-control study was performed on 236 robotic myomectomies at a university medical center. After 1:1 propensity score matching for the total myoma number, total myoma diameter, and patient age, 90 patients in each group (RSS: n = 90; RMP: n = 90) were evaluated. Patient demographics, preoperative parameters, intraoperative characteristics, and postoperative outcome measures were analyzed.

Results: The body mass index, parity, preoperative hemoglobin levels, mean maximal myoma diameter, and anatomical type of myoma showed no mean differences between RSS and RMP myomectomies. The RSS group was younger, had lesser number of myomas removed, and had a smaller sum of the maximal diameter of total myomas removed than the RMP group. After propensity score matching, the total operative time (RSS: 150.9 ± 57.1 min vs. RMP: 170 ± 74.5 min, p = 0.0296) was significantly shorter in the RSS group. The RSS group tended to have a longer docking time (RSS: 9.8 ± 6.5 min vs. RMP: 8 ± 6.2 min, p = 0.0527), shorter console time (RSS: 111.1 ± 52.3 min vs. RMP: 125.8 ± 65.1 min, p = 0.0665), and shorter time required for in-bag morcellation (RSS: 30.1 ± 17.2 min vs. RMP: 36.2 ± 25.7 min, p = 0.0684). The visual analog scale pain score 1 day postoperatively was significantly lower in the RSS group (RSS: 2.4 ± 0.8 days vs. RMP: 2.7 ± 0.8 days, p = 0.0149), with similar consumption of analgesic drugs. The rate of transfusion, estimated blood loss during the operation, and length of hospital stay were not different between the two modalities. No other noticeable complications were observed in either group.

Conclusions: Da Vinci RSS myomectomy is a compatible option with regard to reproducibility and safety, without significantly compromising the number and sum of the maximal diameter of myomas removed. The advantage of shorter total operative time and less pain with the same amount of analgesic drugs in RSS myomectomy will contribute to improving patient satisfaction.
Files in This Item:
T202104564.pdf Download
DOI
10.1186/s12893-021-01245-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Park, Joo Hyun(박주현)
Seo, Seok Kyo(서석교) ORCID logo https://orcid.org/0000-0003-3404-0484
Ahn, So Hyun(안소현)
Lee, Myeongjee(이명지)
Lee, Byung Seok(이병석) ORCID logo https://orcid.org/0000-0001-6001-2079
Cho, Si Hyun(조시현) ORCID logo https://orcid.org/0000-0003-2718-6645
Choi, Young Sik(최영식) ORCID logo https://orcid.org/0000-0002-1157-4822
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186761
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