title: Robotic-assisted laparoscopic complex myomectomy: a single medical center's experience.
abstract: OBJECTIVE
  Conventional laparoscopic myomectomy (LM) has inherent limitations due to its rigid structure. The robotic system is a newly developed technology equipped with a flexible EndoWrist that offers good performance in delicate motions. Our objective was to share our clinical experience in the management of complex myomectomy using this robotic system.
  
  
  METHODS
  From October 2010 to March 2012, 21 patients with symptomatic complex uterine myomas were evaluated. Complex myomectomy was defined as surgery involving more than two fibroids, large fibroids, or preexisting pelvic adhesions. We recorded and analyzed the preoperative characteristics of the patients and the fibroids, the detailed surgical time, and several postoperative outcomes to evaluate the feasibility and efficacy of robotic-assisted LM (RALM) for complex fibroids.
  
  
  RESULTS
  A total of 21 patients were enrolled in this study. The mean age of the patients was 40.1 ± 4.5 years and the mean size of the largest fibroid was 7.3 ± 3.5 cm. RALM achieved satisfactory results, including a short postoperative hospital stay (3.1 ± 0.9 days), a low conversion rate (none of our patients required conversion to either a minilaparotomy or conventional open surgery), and a low complication rate (1 case in 21 patients, 4.8%). The average estimated blood loss was 235.7 ± 283.3 mL.
  
  
  CONCLUSIONS
  Our study results demonstrated that RALM is a safe and effective method for handling complex fibroids.
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Hsin-Yi
authors: HY
authors: Cheng
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: chenyj@vghtpe.gov.tw.
authors: Yi-Jen
authors: YJ
authors: Chen
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Peng-Hui
authors: PH
authors: Wang
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Hsiao-Wen
authors: HW
authors: Tsai
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Yen-Hou
authors: YH
authors: Chang
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Nae-Fang
authors: NF
authors: Twu
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Chi-Mou
authors: CM
authors: Juang
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Huahsi
authors: H
authors: Wu
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Ming-Shyen
authors: MS
authors: Yen
authors: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Kuan-Chong
authors: KC
authors: Chao
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009214:Myoma / Q000601:surgery*; D061646:Operative Time; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: complex myomectomy; laparoscopic myomectomy; robotic myomectomy