Robot-Assisted Laparoscopic Myomectomy

Specialist:
Yi-Jen Chen
Ling-Yu Jiang

Overview

Uterine fibroid disease affects 20-30% of women of childbearing age and 70% of those over 49 years of age. Based on their location, these fibroids can be classified as submucosal, intramural, and sub-serosal. Some women with fibroids may not experience any symptoms, while others may experience heavy bleeding, urinary frequency, constipation, or lower back pain. Abnormal bleeding, dysmenorrhea, or cramping may also occur. Women with submucosal or intramural fibroids that distort the endometrial cavity may experience infertility problems. Treatment is indicated for patients with symptoms.

Features

Robot-assisted Laparoscopic Myomectomy offers advantages over traditional laparoscopic myomectomy, including 3D visualization, magnification of the operating field, tremor filtration, stability of the image, micro-motion of instruments, 360-degree amplitude, facilitated dissection, improved accessibility, and ease of suturing. The robot provides greater surgical precision and allows for the completion of more complex cases compared to laparoscopic surgery.

Procedure

Robot-assisted Laparoscopic Myomectomy is performed using a monopolar scissor and a dipolar grasping device. In some cases, the fourth arm of the robot is used to provide traction on the fibroid. The fibroid is excised and removed from the surrounding uterine tissue after making an incision in the uterus. The uterus is then sutured, and the robot is removed. The myomectomy site is sutured by the robotic arms. A contained morcellator is used to cut the fibroid into smaller pieces, then placed in a tissue bag to reduce the risk of dissemination. An anti-adhesion material may be applied at the end of the procedure.

Notification Risks and Complications

• Adhesion formation at the myomectomy site

• Hemorrhage or major vessel perforation

• Postoperative infection

• Major organ injury

• Uterine rupture in future pregnancies