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Comparison Between Robotic (RM) and Laparoscopic Myomectomy (LM)

Not Applicable
Conditions
Uterine Leiomyoma
Surgical Procedure, Unspecified
Interventions
Procedure: RM
Procedure: LM
Registration Number
NCT04282863
Lead Sponsor
Taipei Medical University Shuang Ho Hospital
Brief Summary

This is a single-blinded RCT evaluating the effect of robotic-assisted (RM) or conventional laparoscopic surgery (LM) in the management of uterine leiomyomas.

Detailed Description

Uterine fibroids are the most common benign tumors of the uterus and may be presented 20%-40% of women at reproductive age.The uterine fibroids can be asymptomatic without intervention. However, they often are the cause of abnormal uterine bleeding, pelvic pain, infertility, and even miscarriage. Myomectomy, rather than hysterectomy can be one option for symptomatic women who wish to preserve their childbearing capabilities or for reasons other than for fertilit. Nowadays, patients pursue cosmetic benefit and early recovery and prompted the search for more conservative and minimally invasive surgical methods when surgical intervention is inescapable and surgical devices are improved.

The feasibility, safety and advantage of cosmetics of laparoscopic myomectomy (LM) has been confirmed after the improvement of techniques and instruments. However, it is very "unfriendly" for our surgeons because of many disadvantages such as keeping stand for long time, unable to relying on, or swaying visual field by first-assistant, etc. Since the approval by the US Food and Drug Administration (FDA) in April 2005, robotic surgeries using the da Vinci Surgical System (Intuitive surgical Inc., Sunnyvale, CA, USA) have been applied widely in many surgical fields including gynecology, urology, orthopedics, general surgery and cardiothoracic surgery. The three-dimensional vision system and the wrist-like structure of EndoWrist instruments (Intuitive surgical Inc., Sunnyvale, CA, USA) recapitulating the motion of the surgeon's hand make precise procedures easier than in conventional laparoscopy, which allows robotic surgery to overcome some of the shortcomings and limitations of traditional laparoscopy. Dr. Lai and colleagues had also successfully undergone robotic surgery in many complicated gynecologic diseases in Taiwan.

However, how to choose or apply robotic-assisted (RM) or conventional laparoscopic surgery (LM) in the management of uterine leiomyomas is still an important issue for our surgeon. We still lack clear definitions about which one kind of myoma may be smoothly performed in RM or LM. The current study is aimed to compare the clinical outcome and efficacy of these 2 minimally invasive procedure in myomectomy, RM and LM, for women with symptomatic uterine fibroids, in this prospective randomised control trial.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
494
Inclusion Criteria
  • All women who has symptomatic benign myoma.
Exclusion Criteria
  • Patient is unwilling the scheduled operation after randomization.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
robotic-assisted laparoscopic myomectomy (RM)RMAfter randomization, participants who are assigned to the robotic-assisted laparoscopic myomectomy (RM) agree to receive RM.
Conventional laparoscopic myomectomy (LM)LMAfter randomization, participants who are assigned to the Conventional laparoscopic myomectomy (LM) agree to receive LM.
Primary Outcome Measures
NameTimeMethod
Conversion rateThe surgical 1 day

To compare the conversion rate between RM and LM

Secondary Outcome Measures
NameTimeMethod
The time of surgeryThe surgical 1 day
The stay length of hospitalizationThrough hospitalization duration, an average of 1 week
The dosage of antipyreticThrough hospitalization duration, an average of 1 week
The amount of blood loss and transfusionThrough hospitalization duration, an average of 1 week
Readmission rateWithin 1 month after discharge
Myoma scoreThrough study completion, an average of 2 years

The score of myoma characteristics

Trial Locations

Locations (1)

Taipei Medical University Shuang Ho Hospital

🇨🇳

Taipei, Taiwan

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