Abstract
Solid scientific evidence indicates that minimally invasive myomectomy provides clinical advantages over its classic open counterpart, and should therefore represent the gold-standard for most patients. In spite of this, the adoption of laparoscopic myomectomy at over two decades from its introduction has been limited, due to the objective technical challenges that it can present. Every minimally invasive surgeon has a safety threshold when it comes to any operation. We argue that, for many surgeons, becoming facile with computer–assisted laparoscopic myomectomy can contribute to raise their personal threshold for resorting to the open approach. The main technical steps of robot-assisted myomectomy as well as several techniques of contained tissue extraction are illustrated.
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References
Alessandri F, Lijoi D, Mistrangelo E, Ferrero S, Ragni N. Randomized study of laparoscopic versus minilaparotomic myomectomy for uterine myomas. J Minim Invasive Gynecol. 2006;13:92–7.
Cicinelli E, Tinelli R, Colafiglio G, Saliani N. Laparoscopy vs minilaparotomy in women with symptomatic uterine myomas: a prospective randomized study. J Minim Invasive Gynecol. 2009;16:422–6.
Fanfani F, Fagotti A, Bifulco G, Ercoli A, Malzoni M, Scambia G. A prospective study of laparoscopy versus minilaparotomy in the treatment of uterine myomas. J Minim Invasive Gynecol. 2005;12:470–4.
Palomba S, Zupi E, Falbo A, et al. A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes. Fertil Steril. 2007;88:933–41.
Seracchioli R, Manuzzi L, Vianello F, et al. Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy. Fertil Steril. 2006;86:159–65.
Mais V, Ajossa S, Guerriero S, Mascia M, Solla E, Melis GB. Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol. 1996;174:654–8.
Jin C, Hu Y, Chen XC, et al. Laparoscopic versus open myomectomy–a meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2009;145:14–21.
Sizzi O, Rossetti A, Malzoni M, et al. Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol. 2007;14:453–62.
Garnet JD. Uterine rupture during pregnancy. An analysis of 133 patients. Obstet Gynecol. 1964;23:898–905.
Parker WH, Einarsson J, Istre O, Dubuisson JB. Risk factors for uterine rupture after laparoscopic myomectomy. J Minim Invasive Gynecol. 2010;17:551–4.
Spong CY, Landon MB, Gilbert S, et al. Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol. 2007;110:801–7.
Pitter MC, Gargiulo AR, Bonaventura LM, Lehman JS, Srouji SS. Pregnancy outcomes following robot-assisted myomectomy. Hum Reprod. 2013;28:99–108.
Liu G, Zolis L, Kung R, Melchior M, Singh S, Cook EF. The laparoscopic myomectomy: a survey of Canadian gynaecologists. J Obstet Gynaecol Can. 2010;32(2):139–48.
Einarsson JI, Matteson KA, Schulkin J, Chavan NR, Sangi-Haghpeykar H. Minimally invasive hysterectomies-a survey on attitudes and barriers among practicing gynecologists. J Minim Invasive Gynecol. 2010;17(2):167–75.
Falcone T, Parker WH. Surgical management of leiomyomas for fertility or uterine preservation. Obstet Gynecol. 2013;121:856–68.
Advincula AP, Song A, Burke W, Reynolds RK. Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2004;11:511–8.
Ascher-Walsh CJ, Capes TL. Robot-assisted laparoscopic myomectomy is an improvement over laparotomy in women with a limited number of myomas. J Minim Invasive Gynecol. 2010;17:306–10.
Barakat EE, Bedaiwy MA, Zimberg S, Nutter B, Nosseir M, Falcone T. Robotic-assisted, laparoscopic, and abdominal myomectomy: a comparison of surgical outcomes. Obstet Gynecol. 2011;117:256–65.
Bedient CE, Magrina JF, Noble BN, Kho RM. Comparison of robotic and laparoscopic myomectomy. Am J Obstet Gynecol. 2009;201:566.e1–5.
Gargiulo AR, Srouji SS, Missmer SA, Correia KF, Vellinga T, Einarsson JI. Robot-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy. Obstet Gynecol. 2012;120:284–91.
Nezhat C, Lavie O, Hsu S, Watson J, Barnett O, Lemyre M. Robotic-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy–a retrospective matched control study. Fertil Steril. 2009;91(2):556–9.
Advincula AP, Xu X, Goudeau 4th S, Ransom SB. Robot-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparison of short-term surgical outcomes and immediate costs. J Minim Invasive Gynecol. 2007;14:698–705.
Nezhat C, Nezhat F, Bess O, Nezhat CH, Mashiach R. Laparoscopically assisted myomectomy: a report of a new technique in 57 cases. Int J Fertil Menopausal Stud. 1994;39:39–44.
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Gargiulo, A.R., Nezhat, C. (2015). Robot-Assisted Myomectomy: Broadening the Laparoscopist’s Armamentarium. In: Tinelli, A., Malvasi, A. (eds) Uterine Myoma, Myomectomy and Minimally Invasive Treatments. Springer, Cham. https://doi.org/10.1007/978-3-319-10305-1_13
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DOI: https://doi.org/10.1007/978-3-319-10305-1_13
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