A Retrospective Study to Compare the Surgical Outcomes of Robotic-assisted Laparoscopic, Laparoscopic, and Abdominal Myomectomies in a Hong Kong Community Hospital

Abstract

Objective: To compare the short-term operative and postoperative outcome of patients who underwent robotic-assisted laparoscopic (RALM), laparoscopic (LM), and abdominal (AM) myomectomies.
Methods: Patients who underwent RALM, LM and AM at Pamela Youde Nethersole Eastern Hospital from January 2007 to August 2014 were retrospectively reviewed.
Results: A total of 17 cases of RALM (9 with conventional technique, 8 with hybrid technique), 20 cases of LM, and 58 cases of AM were included. Patients were similar in age and body weight. The median weight of the fibroids removed in the AM group (286 g) was heavier than the LM group (205 g) and the RALM group (214 g) [p=0.002]. The median operating time of the RALM group was 240 minutes, and was significantly longer than that in the LM group (187.5 mins) and the AM group (69 mins) [p<0.001]. The median length of hospital stay (RALM 4 days, LM 3 days, AM 4 days; p=0.002) was shorter in the laparoscopic group. No significant differences were noted among the three groups for estimated blood loss, and operative and postoperative complications. Significantly more patient-controlled analgesia was used in AM (88%) than RALM (18%) and LM (5%) groups (p<0.001).
Conclusion: AM was more efficient to remove fibroids of heavier weight in a shorter operating time when compared with LM and RALM. Nonetheless patients who underwent RALM and LM had less postoperative pain when compared with AM. LM was associated with least postoperative pain and shortest postoperative hospital stay. RALM was not superior to LM but was at least as safe as other routes of myomectomy.