Comparison of operative and obstetric outcomes in patients diagnosed with myoma using ultrasound

To analyse the operative and obstetric outcomes of single-site robotic myomectomy. We performed a single-centre retrospective cross-sectional study. A total of 286 patients were diagnosed with myoma by ultrasound who underwent single-site robotic myomectomy (70 patients in da Vinci® Xi system and 216 patients in da Vinci® SP system) between April 2019 and November 2021. Data on patient demographics, operative variables (operating time, hemoglobin change, estimated blood loss, return of bowel activity, hospital stay, concomitant surgery, operative complication, conversion to multiport access or laparotomy, and clinical characteristics of the removed fibroids), and obstetric outcomes (the surgery-to-pregnancy interval, pregnancy outcomes, and obstetric complications) were obtained from medical record. The average number of myomas removed was 3.4 ± 2.5 in RSSM and 3.6 ± 3.0 in RSPM; maximal diameter of the largest myoma was 7.7 ± 3.0 cm in RSSM and 7.9 ± 3.4 cm in RSPM. The location of myoma was anterior in 44.1%, posterior in 31.3%, fundal in 12.7%, and lateral in 11.7% of cases. The type of myoma was intramural in 72.3% and subserosal in 27.7%. Conversion to multiport access or laparotomy was seen in 0% of cases. A total of 57 women attempted to become pregnant after surgery. The mean interval from surgery to pregnancy was 7.7 ± 4.1 months in da Vinci® Xi system and 10.3 ± 5.5months in da Vinci® SP system. A total of 37 pregnancies were achieved. There were 9 (24.35%) miscarriage, 1 (2.7%) intrauterine fetal death, 2 (5.4%) ectopic pregnancies, 2 (5.4%) preterm delivery, 18 (48.6%) full-term delivery and 7 (18.9%) ongoing pregnancies. All 20 patients underwent Caesarean section. No instances of obstetric complications were recorded. Single-site robotic myomectomy may be to be an effective procedure with good operative and postoperative obstetric outcomes for women with myomas who wish to preserve fertility.