Rivas LR, Hernández DJA, Audifred SJR, Cervantes MPJ, Durón PR

Language: Spanish
References: 17
Page: 86-91
PDF size: 162.95 Kb.

ABSTRACT

Introduction: Leiomyomas are the most common pelvic tumor in women and they can affect fertility. Myomectomy is the treatment of choice in patients with symptomatic leiomyomas and reproductive purposes. They can be performed using different techniques such as laparotomy, laparoscopic, or robot-assisted. Multiple studies attempt to determine if any of these approaches is superior to another. This study intends to obtain information to choose the best approach for each patient. Objective: Describe and compare three types of approaches to performing myomectomy: Robot-assisted, laparoscopic, laparotomy. Determine if there is any superiority between the three different approaches to myomectomy. Material and methods: Retrospective, analytical, and observational study where 150 cases of myomectomies were reviewed in their different approaches, performed in the Reproductive Medicine Unit of Hospital Angeles Pedregal in Mexico City, 50 by laparotomy, 50 laparoscopic and 50 robot-assisted. Results: The surgical time for robotic surgery was 122 min, laparoscopic 90 min, and laparotomy 85 min. Transoperative bleeding was 50 mL for robotic surgery versus 235 mL for open surgery and 90 mL for laparoscopic surgery. Hospital stay in either of the two minimal access techniques was shorter (1 day) compared to open surgery (2 days). The need for transfusion was greater in open surgery (6%). Regarding complications, they did not occur in any of the three types of surgical approaches. Conversion to laparotomy occurred in two cases of laparoscopic surgery (4%). Conclusion: Conventional and robot-assisted laparoscopic myomectomy showed very similar results. Prospective studies are necessary to specifically determine the advantages between one technique and the other. Robot-assisted laparoscopic myomectomy with only three arms is a safe technique for the treatment of uterine myomatosis.

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