The robotic approach also may allow the gynecologist to remove larger myomas from more unfavorable locations using the same techniques as those employed in laparotomy (Obstet. Gynecol 2011;117:256-65).
Although the cost of robotic myomectomy may be greater than that of myomectomy performed by laparotomy, a standardization of the type and number of instruments used, as well as a reduction in the number of disposables used per case, may result in significant cost savings in an institution that already has a robotic system. A streamlined approach can also potentially result in a cost-neutral scenario when compared with standard laparoscopic myomectomy.
Regarding pregnancies achieved after robotic myomectomies, preliminary data have been positive. We will report studies of long-term experience this fall.
Dr. Pitter disclosed that he is a consultant and on the speaker panel for Intuitive Surgical and is a consultant for Covidien. Dr. Pitter is chief of gynecologic robotic and minimally invasive surgery and a clinical assistant professor of obstetrics and gynecology at Newark (N.J.) Beth Israel Medical Center. He is vice chair of the Robotics Special Interest Group of the AAGL and is a charter member of the Society of Robotic Surgery. He has publications on establishing training criteria in robotic assisted gynecologic surgery, as well as robotic assisted hysterectomy in patients with large uteri.