Comparing clinical outcomes of robot-assisted versus total laparoscopic hysterectomy for symptomatic uterine fibroids

Riho Yazawa, Hyo Kyozuka, Kazuki Anjo, Toma Fukuda, Daisuke Suzuki, Yasuhisa Nomura
In: FUKUSHIMA JOURNAL OF MEDICAL SCIENCE · 2025 · doi:10.5387/fms.25-00018 · PMID:41443818 · W7117232722
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that robot-assisted laparoscopic hysterectomy for uterine fibroids had a longer operative time than total laparoscopic hysterectomy, with uterine length and parity influencing operative time in each approach.

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This retrospective single-institution study compared clinical outcomes between total laparoscopic hysterectomy (TLH) and robot-assisted laparoscopic hysterectomy (RALH) for symptomatic uterine fibroids in 163 premenopausal women in Japan (October 2021 to March 2025), reviewing MRI findings and surgical outcomes. Operative time (skin incision to closure) was significantly longer for RALH than for TLH (median 208 vs. 176 minutes; p < 0.001). Multivariate linear regression stratified by approach found that uterine length was associated with longer operative time in both groups, while parity was associated with reduced operative time specifically in the RALH group. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

OBJECTIVE: This study aimed to compare the clinical outcomes of total laparoscopic hysterectomy (TLH) and robot-assisted laparoscopic hysterectomy (RALH) for treating symptomatic uterine fibroids at a single institution in Japan. Additionally, we identified factors associated with operative time in each surgical approach. METHODS: This retrospective cohort study included 163 premenopausal women with symptomatic uterine fibroids who underwent TLH (n = 119) or RALH (n = 44) between October 2021 and March 2025. Clinical characteristics, magnetic resonance imaging findings, and surgical outcomes were reviewed. Operative time was defined as the time from skin incision to closure. Multivariate linear regression analyses stratified by surgical method were performed to identify factors influencing operative time. RESULTS: Operative time was significantly longer in the RALH than in the TLH group (median:208 vs. 176 min, p < 0.001). Multivariate analysis revealed that uterine length (LU) was associated with longer operative time in both groups, whereas parity was associated with reduced operative time in the RALH group. CONCLUSION: Both UL and parity were independent factors influencing operative time and highlighted the clinical implications of longer operative time in early-phase RALH compared with TLH.
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Keywords

Robot-assisted laparoscopic hysterectomy, total laparoscopic hysterectomy, uterine fibroids, operative time, magnetic resonance imaging Article ID: 25-00018 Details

Abstract

Objective:This study aimed to compare the clinical outcomes of total laparoscopic hysterectomy (TLH) and robot-assisted laparoscopic hysterectomy (RALH) for treating symptomatic uterine fibroids at a single institution in Japan. Additionally, we identified factors associated with operative time in each surgical approach. Methods:This retrospective cohort study included 163 premenopausal women with symptomatic uterine fibroids who underwent TLH (n = 119) or RALH (n = 44) between October 2021 and March 2025. Clinical characteristics, magnetic resonance imaging findings, and surgical outcomes were reviewed. Operative time was defined as the time from skin incision to closure. Multivariate linear regression analyses stratified by surgical method were performed to identify factors influencing operative time. Results:Operative time was significantly longer in the RALH than in the TLH group (median:208 vs. 176 min, p < 0.001). Multivariate analysis revealed that uterine length (LU) was associated with longer operative time in both groups, whereas parity was associated with reduced operative time in the RALH group. Conclusion:Both UL and parity were independent factors influencing operative time and highlighted the clinical implications of longer operative time in early-phase RALH compared with TLH. © 2025 The Fukushima Society of Medical Science This article is licensed under a Creative Commons [Attribution-NonCommercial-ShareAlike 4.0 International] license. https://creativecommons.org/licenses/by-nc-sa/4.0/ Favorites & Alerts Recently viewed articles

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