Feasibility of Reduced-Port Robotic Surgery for Myomectomy with the da Vinci Surgical System

Abstract Study Objective To present our initial experience with reduced-port robotic surgery (RPRS) for myomectomy using the Octo-Port system (DalimSurgNet, Seoul, Korea). Design Prospective and noncomparative study (Canadian Task Force classification II-3). Setting University hospital. Patients Nineteen consecutive patients with symptomatic uterine myomas desiring conservative minimally invasive robotic surgery from October 2015 to December 2016. Interventions An 8.5-mm or 12-mm robotic camera cannula was inserted through 1 of the Octo-Port channels and an 8-mm conventional robotic port was inserted into a 10-mm channel of the Octo-Port through a 3-cm transumbilical incision. An additional 8-mm conventional robotic port was inserted into a typical robotic port site in the patient's right abdomen. Measurements and Main Results Feasibility and operative outcomes of RPRS myomectomy. The median docking time and console time were 10 minutes (range, 4–22) and 90 minutes (range, 29–198). The largest myoma was located on the anterior uterine wall in 11 patients (57.9%). The median myoma size and weight were 7.2 cm (range, 4.1–10.5) and 141 g (range, 42–590), respectively. Median operative blood loss and change in hemoglobin were 100 mL (range, 30–700) and 2.6 mg/dL (range, .1–3.8), respectively. The procedure was successfully performed via RPRS in 89.5% of patients; 2 patients required placement of 1 to 2 additional robotic ports, resulting in a return to traditional multiport robotic surgery. There were no major postoperative complications or postoperative hernias. Conclusion Our experience demonstrated the feasibility of RPRS for myomectomy using the Octo-Port system in selected patients.