Page 22 - WJOLS - Laparoscopic Journal

Meghana Jetty
were generally of advanced maternal age, overweight and 7. Bedient CE, Magrina JF, Noble BN, Kho RM. Comparison of
obese, and had a high prevalence of infertility treatment robotic and laparoscopic myomectomy. Am J Obstet Gynecol
2009;201(6):566e1­566e5.
and multiple births. These risk factors have been associ­ 8. Campo S, Camp V, Gambadauro P. Reproductive outcomes
ated with higher rates of miscarriage, hypertensive before and after laparoscopic or abdominal myomectomy
complications, gestational diabetes and preterm deli­ for subserous or intramural myomas. Eur J Obstet Gynecol
very. 4,9,13,42 Furthermore, women who have IVF pregnan­ Reprod Biol 2003;110(2):215­219.
cies are also at a higher risk for having preterm deliveries 9. Cleary-Goldman J, Malone FD, Vidaver J, Ball RH, Nyberg DA,
and infants of low birthweight. 13,48 Additionally, given the Comstock CH, Saade GR, Eddleman KA, Klugman S, Dugoff L,
et al. Impact of maternal age on obstetric outcome. Obstet
absence of pregnancy outcome data after robotic myo­ Gynecol 2005;105(5 pt 1):983-990.
mectomy in the literature, obstetricians conservatively 10. Diamond MP, Freeman ML. Clinical implications of postsur­
managed these pregnancies as if they had prior classical gical adhesions. Hum Reprod Update 2001;7(6):567­576.
cesarean sections. The present review observed preg­ 11. Dubuisson JB, Chapron C, Chavet X, Gregorakis SS. Fertility
nancy outcomes after RALM that were comparable with after laparoscopic myomectomy of large uterine myomas:
preliminary results. Hum Reprod 1996;11(3):518­522.
those reported in the conventional laparoscopic literature. 12. Dubuisson JB, Fauconnier A, Deffarges JV, Norgaard C,
Robotic surgical techniques can overcome some of the Kreiker G, Chapron C. Pregnancy outcome and deliveries
5
shortcomings of traditional laparoscopy, thus facilitating following laparoscopic myomectomy. Hum Reprod 2000;15(4):
the use of minimally invasive surgery over laparotomy 869­873.
30
for more gynecologic surgeons. This enabling treatment 13. Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal
outcomes in singletons following in vitro fertilization: a
modality may offer a minimally invasive alternative for meta-analysis. Obstet Gynecol 2004;103(3):551-563.
uterine preservation for women with uterine fibroids. 14. Kumakiri J, Tekeuchi H, Kitade M, Kikuchi I, Shimanuki H,
Itoh S, Kinoshita K. Pregnancy and delivery after laparoscopic
CONCLUSION myomectomy. J Minim Invasive Gynecol 2005;12(3):241-246.
15. Kumakiri J, Takeuchi H, Kitade M, Kikuchi I, Takeda S. Pro­
Robot­assisted laparoscopic myomectomy is a safe route spective evaluation for the feasibility and safety of vaginal
of myomectomy. It is superior in terms of lesser tissue birth after laparoscopic myomectomy. J Minim Invasive
Gynecol 2008;15(4):420-424.
trauma, better suturing, better hemostatsis. Pregnancy 16. Kumakiri J, Kikuchi I, Kitade M, Matsuoka S, Kono A, Ozaki R,
outcomes are also comparable to laparoscopic myomec­ Takeda S. Association between uterine repair at laparoscopic
tomy. There is actually lower adhesion rate and better myomectomy and postoperative adhesions. Acta Obstet
pregnancy outcome when compared to laparoscopic and Gynecol Scand 2012;91(3):331-337.
abdominal myomectomy. But further studies are needed 17. Landi S, Fiaccavento A, Zaccoletti R, Barbieri F, Syed R,
to know the long­term effects. Presently, it is the safest Minelli L. Pregnancy outcomes and deliveries after laparos­
copic myomectomy. J Am Assoc Gynecol Laparosc 2003;10(2):
method of myomectomy. 177­181.
18. Liu G, Zolis L, Kung R, Melchoir M, Singh S, Cook EF. The
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