Introduction: The commercial availability of robotic da Vinci surgical system (Intuitive Surgical inc., Sunnyvale, California, USA) has attracted the gynecologic surgeon\'s interest due to proposed favorable surgical ergonomics, greater precision in dissection, and easier suturing as well as knot tying. Robot-assisted laparoendoscopic single-site surgery appears to be encouraging for more suture-intensive surgeries like myomectomy as it offers potential in resolving the ergonomic challenges imposed by the restrictive range of motion and vision of conventional LESS.
Aim: The aim of this review is to appraise the available literature on robot-assisted laparoendoscopic single-site (RA-LESS) myomectomy and comment on the feasibility, reproducibility, learning curve as well as financial implications of this technique.
Results: The studied outcome measures of mean operative time, estimated blood loss, and number and type of myomas removed suggest that this is a feasible technique. It was found to be a safe procedure with no reported intraoperative complications or conversions and negligible postoperative complications. The data on financial implication are, however, limited.
Conclusion: Current initial data indicate that RA-LESS is a promising technique. It is a safe and reproducible procedure for performing myomectomy. However, more studies with larger cohorts and long-term follow-ups are needed to conclusively recommend this technique for a wider application.
Clinical significance: With increasing experience in minimal invasive techniques and availability of single-port da Vinci surgical system, more challenging surgeries like myomectomy can be safely performed to optimize clinical benefits to the patients.
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