Postoperative Outcomes After Robotic Versus Abdominal Myomectomy

Background and Objectives: Differences in postopera-tive outcomes comparing robotic-assisted laparoscopic myomectomy (RALM) with abdominal myomectomy (AM) have rarely been reported. The objective of this study was to compare surgical, quality-of-life, and residual fibroid outcomes after RALM and AM. Methods: Consecutive patients who underwent RALM (n 16) were compared with AM patients (n 23) presenting with a uterine size of 20 weeks. Study pa-tients participated in a telephone interview at 6 weeks and underwent a no-cost ultrasonographic examination at 12 weeks after surgery to obtain quality-of-life and residual fibroid outcomes. Medical records were reviewed to ob-tain surgical outcomes. Results: Longer operative times (261.1 minutes vs 124.8 minutes, P .001) and a 3-fold unfavorable difference in operative efficiency (73.7 g vs 253.0 g of specimen re-moved per hour, P .05) were observed with RALM compared with AM. Patients undergoing RALM had shorter lengths of hospital stay (1.5 days vs 2.7 days, P .001). Reduction of patient symptoms and overall satisfac-tion were equal. RALM patients were more likely to be back to work within 1 month (85.7 % vs 45.0%, P .05). Residual fibroid volume in the RALM group was 5 times greater than that in the AM group (17.3 cm3 vs 3.4 cm3, P .05). Conclusion: RALM and AM were equally efficacious in improving patient symptoms. Although operative times were significantly longer with RALM, patients had a quicker recovery, demonstrated by shortened lengths of stay and less time before returning to work. However, greater residual fibroid burden was observed with RALM when measured 12 weeks after surgery. Key Words: Myomectomy, Noninvasive surgery, Robot-assisted laparoscopic myomectomy, Abdominal myomec