Postoperative Complications in Laparoscopic versus Robotic Myomectomy: A Systematic Review and Meta-analysis
- Journal
- Journal of minimally invasive gynecology (Q2)
- Published
- 24 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Gabriella Ferreira Marucci da Silva, Lorena Burim Bernardo da Silva, Maria Luísa de Andrade Reis, Sophia Murad Macedo Nunes, Vanessa de Oliveira Silveira, Omero Benedicto Poli Neto, et al.
- PMID
- 42498219
- DOI
- 10.1016/j.jmig.2026.07.021
Why clinicians should know about it
- Picked for Obstetrics and Gynecology (top studies of the week, 26 July 2026).
Abstract
OBJECTIVE: To compare postoperative complications associated with robotic and laparoscopic myomectomy in women with symptomatic uterine leiomyomas and to inform clinical decision-making. DATA SOURCES: A comprehensive search was conducted in PubMed, EMBASE, and Scopus with no date restrictions. The search strategy included the following terms: "Leiomyoma" OR "Uterus myoma" OR "Fibroids" AND "Robotic surgical procedures" OR "Robotic assisted surgery" AND "Laparoscopy" OR "Uterine myomectomy" AND "Postoperative complications." METHODS OF STUDY SELECTION: The initial search yielded 398 articles. After duplicate removal and application of selection criteria, 19 studies were included in the systematic review. Both randomized controlled trials and observational studies evaluating clinical outcomes in women with symptomatic uterine leiomyomas undergoing robotic or laparoscopic myomectomy were included. TABULATION, INTEGRATION, AND RESULTS: A total of 2,510 patients were analyzed (1,366 underwent laparoscopic myomectomy and 1,144 robotic myomectomy). Robotic myomectomy was associated with significantly lower blood loss (MD 36.35 mL; 95% CI 0.53-72.18) and lower conversion rates to laparotomy (RR 0.46; 95% CI: 0.28 to 0.75) compared with laparoscopy. No significant differences were observed in hemoglobin drop (MD 0.03 g/dL; 95% CI -0.26 to 0.20), transfusion rates (RR 1.14; 95% CI 0.76-1.70), postoperative complications (RR 1.06; 95% CI 0.59-1.89), or postoperative fever (RR 0.47; 95% CI 0.12-1.82). CONCLUSIONS: Robotic myomectomy demonstrated advantages over laparoscopy in terms of reduced blood loss and lower conversion rates to laparotomy. Other postoperative outcomes presented no significant differences between the two techniques. These findings support the safety of both approaches and may guide surgical decision-making based on patient characteristics and resource availability.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.