Comparative Study on Standard Laparoscopic Myomectomy and Robotic-assisted Laparoscopic Myomectomy

Abstract Background: A myomectomy is a surgical procedure designed to eliminate noncancerous uterine fibroids, growths within the uterus. Despite many studies, there is still no consensus on whether robotic myomectomy is superior to laparoscopic myomectomy (LM). Aims: This study aims to compare the outcomes of standard LM and robotic-assisted LM (RALM) in the treatment of uterine fibroids. Settings and Design: A prospective comparative analysis. Subjects and Methods: A prospective comparative analysis was conducted on 49 patients among which 30 undergoing LM and 19 undergone robotic-assisted LM (RALM) at our institution between January 2023 and December 2023. Data on operative time, conversion rate to open surgery, postoperative complications, length of hospital stay, and cost were collected and analyzed. Statistical Analysis Used: Mean difference between the groups was assessed with the help of t -test, and association between the variables was assessed with the help of the Chi-square or Fisher exact test. P < 0.05 was considered as statistically significant. Results: A total of 49 patients were included in the study, with 30 undergoing LM and 19 undergoing RALM. The mean operative time was significantly longer in the RALM group (186 min) compared to the LM group (167 min) ( P < 0.05). However, the estimated blood loss was significantly lower in the RALM group (287 mL) compared to the LM group (490 mL) ( P < 0.05). There was a significant difference in the length of hospital stay between the two groups. The incidence of intraoperative and postoperative complications was similar between the two groups. There was no significant difference in fibroid recurrence rates at 1-year follow-up. Conclusions: Robotic-assisted LM offers advantages over standard LM in terms of reduced blood loss and lower conversion rates to open surgery. However, it is associated with longer operative times.