Robotic Single-Site Plus One-Port Myomectomy Versus Robotic Single-Site Plus Two-Port Myomectomy: A Propensity Score Matching Analysis

Overview

Journal Yonsei Med J

Specialty General Medicine

Date 2024 Jun 24

PMID 38910303

Authors

Su Hyeon Choi

Seyeon Won

Nara Lee

So Hyun Shim

Mi Kyoung Kim

Mi-La Kim

Yong Wook Jung

Bo Seong Yun

Hye Sun Jun

Seok Ju Seong

Affiliations

Soon will be listed here.

Abstract

Purpose: Robotic single-site plus one-port myomectomy (RSOM) was designed to reduce the number of incision sites for greater cosmetic satisfaction of patients while retaining the benefits of conventional robotic multi-site myomectomy (CRM). Robotic single-site plus two-port myomectomy (RSTM) eliminated one port relative to conventional CRM, and RSOM achieved the same advantage with respect to RSTM. This study aimed to compare RSOM with RSTM in terms of their respective methodologies and surgical outcomes.

Materials And Methods: The medical records of 230 patients who had undergone RSOM and 146 patients who had undergone RSTM were reviewed. The groups' surgical outcomes were compared using propensity score matching (PSM) analysis.

Results: In the total data, RSOM had a shorter operative time (135.1±57.4 min vs. 149.9±46.2 min, =0.009) and a shorter hospital stay (5.2±0.5 days vs. 5.4±0.7 days, =0.033) relative to RSTM. The PSM analysis showed that there were no statistically significant intergroup differences in the patients' baseline characteristics. Regarding the surgical outcomes, the RSOM group showed shorter operative time (129.2±49.3 min vs. 148.7±46.3 min, =0.001) compared to the RSTM group.

Conclusion: Compared with RSTM, RSOM was associated with shorter operative time. Additionally, more detailed comparative and prospective studies are needed to evaluate RSOM relative to RSTM.

References

Advincula A, Song A, Burke W, Reynolds R . Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2005; 11(4):511-8. DOI: 10.1016/s1074-3804(05)60085-0. View

Raakow J, Klein D, Barutcu A, Biebl M, Pratschke J, Raakow R . Single-port versus multiport laparoscopic surgery comparing long-term patient satisfaction and cosmetic outcome. Surg Endosc. 2020; 34(12):5533-5539. PMC: 7644529. DOI: 10.1007/s00464-019-07351-3. View

Lonnerfors C, Persson J . Pregnancy following robot-assisted laparoscopic myomectomy in women with deep intramural myomas. Acta Obstet Gynecol Scand. 2011; 90(9):972-7. DOI: 10.1111/j.1600-0412.2011.01207.x. View

Nam S, Paek J, Choi C, Nam S, Kim W . A comparison between reduced-port robotic surgery and multiport robot-assisted laparoscopy for myomectomy. Eur J Obstet Gynecol Reprod Biol. 2017; 213:53-57. DOI: 10.1016/j.ejogrb.2017.04.009. View

de Joliniere J, Librino A, Dubuisson J, Khomsi F, Ben Ali N, Fadhlaoui A . Robotic Surgery in Gynecology. Front Surg. 2016; 3:26. PMC: 4852174. DOI: 10.3389/fsurg.2016.00026. View

Moawad G, Tyan P, Paek J, Tappy E, Park D, Choussein S . Comparison between single-site and multiport robot-assisted myomectomy. J Robot Surg. 2019; 13(6):757-764. DOI: 10.1007/s11701-019-00919-0. View

Baird D, Dunson D, Hill M, Cousins D, Schectman J . High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003; 188(1):100-7. DOI: 10.1067/mob.2003.99. View

Cela V, Freschi L, Simi G, Tana R, Russo N, Artini P . Fertility and endocrine outcome after robot-assisted laparoscopic myomectomy (RALM). Gynecol Endocrinol. 2012; 29(1):79-82. DOI: 10.3109/09513590.2012.705393. View

Semm K . New methods of pelviscopy (gynecologic laparoscopy) for myomectomy, ovariectomy, tubectomy and adnectomy. Endoscopy. 1979; 11(2):85-93. DOI: 10.1055/s-0028-1098329. View

10.

Palomba S, Zupi E, Russo T, Falbo A, Marconi D, Tolino A . A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: short-term outcomes. Fertil Steril. 2007; 88(4):942-51. DOI: 10.1016/j.fertnstert.2006.12.048. View

11.

Seracchioli R, Rossi S, Govoni F, Rossi E, Venturoli S, Bulletti C . Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: a randomized comparison with abdominal myomectomy. Hum Reprod. 2000; 15(12):2663-8. DOI: 10.1093/humrep/15.12.2663. View

12.

Davey A, Maher P . Surgical adhesions: a timely update, a great challenge for the future. J Minim Invasive Gynecol. 2007; 14(1):15-22. DOI: 10.1016/j.jmig.2006.07.013. View

13.

Haueter R, Schutz T, Raptis D, Clavien P, Zuber M . Meta-analysis of single-port versus conventional laparoscopic cholecystectomy comparing body image and cosmesis. Br J Surg. 2017; 104(9):1141-1159. DOI: 10.1002/bjs.10574. View

14.

Lonnerfors C . Robot-assisted myomectomy. Best Pract Res Clin Obstet Gynaecol. 2017; 46:113-119. DOI: 10.1016/j.bpobgyn.2017.09.005. View

15.

Chittawar P, Franik S, Pouwer A, Farquhar C . Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2014; (10):CD004638. PMC: 10961732. DOI: 10.1002/14651858.CD004638.pub3. View

16.

Iavazzo C, Mamais I, Gkegkes I . Robotic assisted vs laparoscopic and/or open myomectomy: systematic review and meta-analysis of the clinical evidence. Arch Gynecol Obstet. 2016; 294(1):5-17. DOI: 10.1007/s00404-016-4061-6. View

17.

Won S, Choi S, Lee N, Shim S, Kim M, Kim M . Robotic Single-Site Plus Two-Port Myomectomy versus Conventional Robotic Multi-Port Myomectomy: A Propensity Score Matching Analysis. J Pers Med. 2022; 12(6). PMC: 9225652. DOI: 10.3390/jpm12060928. View

18.

Lurje G, Raptis D, Steinemann D, Amygdalos I, Kambakamba P, Petrowsky H . Cosmesis and Body Image in Patients Undergoing Single-port Versus Conventional Laparoscopic Cholecystectomy: A Multicenter Double-blinded Randomized Controlled Trial (SPOCC-trial). Ann Surg. 2015; 262(5):728-34. DOI: 10.1097/SLA.0000000000001474. View

19.

Arezzo A, Passera R, Bullano A, Mintz Y, Kedar A, Boni L . Multi-port versus single-port cholecystectomy: results of a multi-centre, randomised controlled trial (MUSIC trial). Surg Endosc. 2016; 31(7):2872-2880. DOI: 10.1007/s00464-016-5298-7. View