Long-Term Outcomes of Reduced-Port Robotic Surgery (RPRS) for Uterine Myomectomy with the da Vinci Surgical System

Abstract

Background: Reduced-Port Robotic Surgery (RPRS) for myomectomy is feasible alternate method to overcome disadvantages of multiport and single-site platforms of robotic surgery with better cosmetic results. We demonstrated operative outcomes and long-term outcomes after RPRS. Methods: This is analysis of a prospective, non-randomized study of 115 patients who underwent RPRS from April 2016 through July 2021. Results: Overall 115 patients were included for analysis. Patients’ median age was 42 years (range, 28–52). The largest myoma was mostly located on the anterior uterine wall in 59 patients. The median myoma size and weight were 7.5 cm (range, 3–12) and 163 g (range, 42–753), respectively. The median myoma enucleation time and suture time were 10 minutes (range, 4–82) and 14 minutes (range, 5–63). Trend of shorter docking time and console time was shown with experience. The procedure was successfully performed via RPRS in 104 patients (91.5%); 10 patients required placement additional ports, conversion to open surgery was conducted in one case. There were 6 patients (5.2%) with postoperative complication with surgical wound infection (1.7%), bleeding (0.9%), peritonitis (1.7%), and pneumonia (0.9%). For long-term outcomes, 12 recurrences (10.4%) were observed in median follow-up of 25 months (range, 6–62 months). Total of 4 patients became pregnant after RPRS, and three patients had delivered with Caesarean section without complications. Conclusions: Our long-term results demonstrate the safety and feasibility of RPRS for uterine myomectomy as a valid treatment modality.