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Fertil Steril. 2017 Sep;108(3):e1. doi: 10.1016/j.fertnstert.2017.06.030.

Versatility of the suprapubic port in robotic assisted laparoscopic myomectomy.

Author information

1
Department of Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
2
Department of Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: falcont@ccf.org.

Abstract

OBJECTIVE:

To demonstrate the multiple advantages of the suprapubic port in robotic assisted laparoscopic myomectomy.

DESIGN:

Video demonstration of a robotic assisted laparoscopic myomectomy technique using a suprapubic incisional retractor (GelPOINT).

SETTING:

Hospital.

PATIENT(S):

A 32-year-old primigravid women with heavy menstrual bleeding and pelvic pain with a 12-cm leiomyoma (International Federation of Gynecology and Obstetrics type 5).

INTERVENTION(S):

Illustrate a surgical approach during robotic assisted laparoscopic myomectomy with the use of a 5-cm suprapubic incision, an incisional retractor (GelPOINT) for the enucleation, and extraction of a large leiomyoma.

MAIN OUTCOME MEASURE(S):

The effective enucleation and extraction of a leiomyoma specimen using an incisional retractor and GelPOINT. The steps of the technique and the role of GelPOINT are demonstrated.

RESULT(S):

The procedure was performed without incident, and the patient experienced pain relief and lighter menses postoperatively. This technique has been performed successfully since June 2014 on 22 women.

CONCLUSION(S):

During a robotic assisted laparoscopic myomectomy the suprapubic incision is both advantageous and practical. The small incision allows the surgery to remain minimally invasive; the primary umbilical trocar is inserted under direct visualization in an already insufflated abdomen; the location of the incision allows the surgical assistant easy access to the port; the passing of the needles occurs under direct visualization with minimal camera manipulation; and last, the extraction of large tissue can be performed within a specimen pouch through this same suprapubic incision in a short period.

KEYWORDS:

GelPOINT incisional retractor; minimally invasive; robotic assisted myomectomy; suprapubic port

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[Indexed for MEDLINE]

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