AB045. SOH22ABS038. Robotic-assisted benign gynaecological surgery—the Limerick experience

Background: Robotic surgery has many benefits, including reduced length of stay, quicker recovery and better outcomes compared to open and laparoscopic surgery. Patients with high body mass index (BMI) or large fibroids in particular can be successfully treated with minimal access robotic surgery. University Hospital Limerick (UHL) introduced the Da Vinci Xi robot for gynaecological patients in 2019. In this study, we report patient outcomes and complications post robotic-assisted surgery in UHL.

Methods: Data was prospectively collected from January 2019 to present. Patient characteristics, intraoperative outcomes and postoperative length of stay and complications were assessed.

Results: A total of 50 cases were completed from January 2019 to September 2021. There were 2 cases per list, with 22 in the first year, and fewer in the second year due to the coronavirus disease 2019 (COVID-19) pandemic. All patients were admitted on the day of surgery. Mean body mass index (BMI) was 32 kg/m², with 32% patients having a BMI >35, the highest being a BMI of 60. There were 37 hysterectomies ± BSO and 13 myomectomies. The rate of complications within 30 days postoperatively was low at two cases (4%), and there were no cases of post-operative infections. Only one procedure required conversion to open (2%). For myomectomies, mean fibroid weight was 196 g, with the largest fibroid extracted weighing 885 g. Mean blood loss was 119 mLs, with an average operation time of 2 hours 34 minutes. Average length of stay was 1 day.

Conclusions: Robotic surgery in Limerick has been successfully used to treat patients with high BMI and for removal of large fibroids with excellent clinical outcomes.

Keywords: Excellent patient outcomes; high body mass index (high BMI); large fibroids; reduced length of stay; robotic-assisted surgery