Mayo Clinic Study: No Significant Differences Comparing Robotic Vs Laparoscopic Surgical Removal of Uterine Fibroids

Friday, September 25, 2009

SCOTTSDALE, Ariz. — Uterine fibroids, muscular tumors that grow on the wall of the uterus, affect 35 percent of women by the time they reach 50.

Some fibroids are asymptomatic. Others, however, cause significant pain, bleeding, swelling and pregnancy problems. In rare cases, they can be cancerous.

Researchers at Mayo Clinic are evaluating the best, least-invasive ways of surgically removing uterine fibroids, avoiding the more traditional open surgery, where a large incision is made through the abdominal wall to gain access to the uterus.

A study, led by Javier Magrina, M.D., Gynecologic Surgery, and Rosanne Kho, M.D., Gynecologic Surgery, evaluated 81 patients with benign fibroid tumors — 40 who underwent robotic surgery and 41 who underwent laparoscopic surgery.

Both robotic and laparoscopic surgeries to remove fibroids are considered minimally invasive procedures. Robotic technology allows surgeons a three-dimensional view of the surgical field with more depth perception than traditional open surgery, and gives magnification 10 times greater than the human eye. The surgeon is able to remove the fibroid tissue, preserving the uterus for future pregnancies.

The surgical outcomes for both laparoscopy and robotic-assisted surgery were similar. If there was an edge at all, it was the robotic procedure, given that the overall complication rate was somewhat lower. Also, the robotic procedure has advantages for the surgeon because of the three-dimensional images, the articulation of the instruments, absence of tremor and the ability for the surgeon to be seated during the procedure.

If there are disadvantages to patients with either of these two procedures, it is that they cannot be applied to patients with large fibroids. Both techniques, however, are preferable to the traditional open incision because there is less blood loss, shorter hospital stays and fewer post-operative complications.

"We are able to conclude, from these initial results based on our sample size, that there were no significant, short-term differences in surgical outcomes between robotic and laparoscopic removal of uterine fibroids," said Dr. Magrina. "A prospective, randomized trail would be optimal to clarify the definitive advantages of robotic versus laparoscopic surgery."

Study results, published in the American Journal of Obstetrics and Gynecology, reviewed patient results from Feb. 1, 2000 through March 31, 2008.

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