Abstract
Introduction: Uterine fibroids are common benign tumors; however, giant fibroids are rare, and their minimally invasive surgical management represents a significant challenge, particularly in countries where robotic surgery is newly implemented.We present a complex case from our specialty—a robotic hysterectomy for uterine myomatosis—in which the surgical specimen weighed 1,065 grams, successfully treated using this approach. Case presentation: A 50-year-old woman with a history of hypothyroidism and iron- deficiency anemia due to chronic menorrhagia was evaluated. Pelvic MRI revealed a giant subserosal fibroid (FIGO type 6) measuring approximately 14 cm in the uterine fundus. A total hysterectomy with bilateral salpingectomy was performed using the Da Vinci robotic system, achieving complete removal of a myomatousuterus weighing 1,065 grams (345 grams of uterus and tubes and a 720-gram fibroid). The procedure was completed without intraoperative complications or conversion to laparotomy. The patient had a favorable postoperative course, required no transfusions, and was discharged the following day. Conclusions: This case demonstrates the feasibility and safety of roboticsurgery in the management of giant uterine fibroids, even in resource-limited settings. The enhanced 3D visualization and precision of the robotic platform facilitated resection and suturing in a markedly enlarged uterus, resulting in minimal blood loss and rapid recovery. With appropriate preoperative planning and a multidisciplinary approach, robotic-assisted surgeryemerges as an effective and minimally invasive alternative for large fibroids. This experience supports the expansion of gynecologic robotic surgery in Latin America, enabling more patients to benefit from its advantages.
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