Comparison of perioperative outcomes among robot-assisted, conventional laparoscopic, and abdominal/open myomectomies

OBJECTIVE: To compare the perioperative results of myomectomy performed by robotic surgery (RM), laparoscopic surgery (LM), and open/abdominal surgery (OM). MATERIAL AND METHODS: We included 227 patients who underwent either robotic (n=66), laparoscopic (n=88), or abdominal (n=73) myomectomy at our hospital between 2016 and 2020. Retrospective medical records, including fibroid characteristics, demographic findings, and surgical outcomes, were compared. RESULTS: The RM group had a significantly lower body mass index and significantly larger uterine size, myoma diameter, and myoma weight than the other groups. However, the OM group had the highest number of myoma. Moreover, the RM group had higher operative time and blood loss but significantly lower maximum visual analog scale values than the OM and LM groups. Hospitalization duration was significantly different among the groups. The rate of 1-day hospitalization was 56.2%, 64.8%, and 37.9% in the OM, LM, and RM groups, respectively. Furthermore, blood transfusion requirement was significantly higher in the OM group (12.3%) than in the LM and RM groups (0.0% and 4.5%, respectively). CONCLUSION: Minimally invasive myomectomy may be preferable, particularly for women of reproductive age. In women with large uterine size and myoma, robot-assisted LM is recommended.