Robotic myomectomy was performed using three robotic arms and standard laparoscopic trocars, as the system does not require proprietary ports. (1) The approach was selected based on favorable fibroid size and location. Although robotic assistance is not indispensable, it may facilitate precise multilayer suturing and effective hemostatic control in fertility-preserving surgery. Low abdominal port placement was adopted for improved cosmetic results, acknowledging that this configuration may not be suitable for larger uteri. Hemostasis included temporary bilateral uterine artery clipping and intramyometrial vasopressin injection. Monopolar and bipolar energy were used. Specimen extraction was performed transvaginally using a protective bag; alternative contained cold-scalpel morcellation techniques may be considered in selected nulliparous patients. Operative time was 122 minutes, with 50 mL estimated blood loss and no complications. (2) CONCLUSION: Robotic myomectomy with the Hugo™ RAS platform demonstrated feasible and safe performance in this selected case. There are currently no comparative studies supporting superiority over other robotic systems.
Arcas et al. (Sun,) studied this question.