Long-Term Outcomes of Reduced-Port Robotic Surgery (RPRS) for Uterine Myomectomy with the da Vinci Surgical System

Background: Reduced-Port Robotic Surgery (RPRS) for myomectomy is feasible alternate method to overcome disadvantages of multiport and single-site platforms of robotic surgery with better cosmetic results. We demonstrated operative outcomes and long-term outcomes after RPRS. Methods: This is analysis of a prospective, non-randomized study of 115 patients who underwent RPRS from April 2016 through July 2021. Results: Overall 115 patients were included for analysis. Patients' median age was 42 years (range, 28-52). The largest myoma was mostly located on the anterior uterine wall in 59 patients. The median myoma size and weight were 7.5 cm (range, 3-12) and 163 g (range, 42-753), respectively. The median myoma enucleation time and suture time were 10 minutes (range, 4-82) and 14 minutes (range, 5-63). Trend of shorter docking time and console time was shown with experience. The procedure was successfully performed via RPRS in 104 patients (91.5%); 10 patients required placement additional ports, conversion to open surgery was conducted in one case. There were 6 patients (5.2%) with postoperative complication with surgical wound infection (1.7%), bleeding (0.9%), peritonitis (1.7%), and pneumonia (0.9%). For long-term outcomes, 12 recurrences (10.4%) were observed in median follow-up of 25 months (range, 6-62 months). Total of 4 patients became pregnant after RPRS, and three patients had delivered with Caesarean section without complications. Conclusions: Our long-term results demonstrate the safety and feasibility of RPRS for uterine myomectomy as a valid treatment modality.