title: Robot-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy.
abstract: OBJECTIVE
  To compare surgical outcomes of laparoscopic myomectomy and robot-assisted laparoscopic myomectomy.
  
  
  METHODS
  Retrospective cohort study of 115 consecutive laparoscopic myomectomy and 174 consecutive robot-assisted laparoscopic myomectomy performed at Brigham and Women's Hospital over a period of 31 months. Uterine incisions were closed in multiple layers (running barbed suture was used for most cases in the laparoscopic myomectomy group). Surgical outcomes measured included operative time, estimated intraoperative blood loss, length of hospital stay, and perioperative complications. Odds ratios and 95% confidence intervals were calculated from multivariable logistic regression models; adjusted geometric means were estimated from linear regression models on logged outcomes because of skewed distributions.
  
  
  RESULTS
  Surgical groups were similar in age, body mass index, and leiomyoma characteristics. Robot-assisted laparoscopic myomectomy had significantly longer operative time than laparoscopic myomectomy (adjusted geometric mean of 195.1 compared with 118.3 minutes, P<.001) and higher estimated blood loss (adjusted geometric mean of 110.0 compared with 85.9 mL, P=.04), but postoperative complications were similar.
  
  
  CONCLUSIONS
  Robot-assisted laparoscopic myomectomy and laparoscopic myomectomy have similar operative outcomes in a high-volume surgical practice. Operative time and intraoperative estimated blood loss were significantly greater in the robot-assisted laparoscopic myomectomy group, but the level of statistical significance for intraoperative estimated blood loss was marginal and the clinical significance was undetermined. Use of barbed suture in the laparoscopic myomectomy group may account for these differences.
  
  
  METHODS
  II.
authors: Department of Obstetrics, Gynecology and Reproductive Biology, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
authors: Antonio R
authors: AR
authors: Gargiulo
authors: Serene S
authors: SS
authors: Srouji
authors: Stacey A
authors: SA
authors: Missmer
authors: Katharine F
authors: KF
authors: Correia
authors: Thomas T
authors: TT
authors: Vellinga
authors: Thomas
authors: T
authors: Vellinga
authors: Jon I
authors: JI
authors: Einarsson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D059032:Learning Curve; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000706:statistics & numerical data*; D014594:Uterine Neoplasms / Q000601:surgery; D055815:Young Adult