Mastering Robotic Myomectomy: Harnessing Knowledge, Technique and Technology for Surgical Excellence

Study Objective

To assess the efficacy and safety of minimally invasive robot-assisted myomectomy in treating a patient with multiple uterine fibroids.

Design

Case report detailing the surgical intervention and outcomes of a patient with symptomatic uterine fibroids.

Setting

Patient in lithotomy position, robot docking at patient pelvic left side, with 3 robotic trocars and one laparoscopic 11mm assistant port.

Patients or Participants

Case report of a 39-year-old woman.

Interventions

The patient underwent treatment with Goserelin acetate to reduce the size of the uterus, followed by minimally invasive robot-assisted myomectomy. During the surgery, uterine arteries and round ligaments were located, clipped, and temporarily clamped to minimize bleeding. Fibroids were meticulously dissected and removed using laparoscopic ultrasound guidance.

Measurements and Main Results

The surgery lasted approximately 3 hours, during which 14 fibroids were removed. Blood loss was minimal, with the patient losing only 100ml. Postoperative recovery was favorable, with the patient experiencing mild abdominal pain and being discharged within 20 hours. Pathology confirmed the removal of all leiomyomas.

Conclusion

Minimally invasive robot-assisted myomectomy, combined with meticulous identification and clipping of uterine arteries, proved effective in reducing uterine size and improving symptoms in this patient with multiple uterine fibroids. This approach offers a promising option for the management of symptomatic fibroids, enhancing patient outcomes and quality of life.