Robot-Assisted Laparoscopic Myomectomy: A Comparison of Techniques

Abstract

Objective: The aim of this study was to determine the differences in perioperative variables between the 3-arm robot-assisted laparoscopic myomectomy technique and the 4-arm technique for the same operation. Materials and Methods: This was a retrospective cohort study from 2009 to 2014. A total of 108 consecutive robot-assisted laparoscopic myomectomies were identified and grouped based upon the use of the 4-arm technique or the 3-arm technique. Demographic and perioperative surgical data (operative time, estimated blood loss, number of fibroids removed, fibroid weight, pain scores, narcotics administered, and length of stay) were collected and analyzed. Linear regression modeling was performed to investigate the effect of the surgical variables on operative time. Results: Mean operative time was 81 minutes shorter (128 versus 218; p < 0.01) in the 4-arm technique group (n = 64), compared to the 3-arm technique group (n = 44). Patient demographics and all other perioperative variables were similar between the two groups. Multivariable regression analysis showed that utilization of the third operative robotic arm in the 4-arm robot-assisted laparoscopic myomectomy technique accounted for an 81-minute decrease in operative time; p < 0.01. Conclusions: The 4-arm robot-assisted laparoscopic myomectomy technique has a significantly shorter operative time, compared to the 3-arm technique, with all other perioperative variables being similar. (J GYNECOL SURG 32:329)