Robotic-assisted laparoscopicomy in minimally symptomatic giant uterine leiomyoma: a case report

Uterine leiomyomas can impair quality of life and fertility. Robotic assistant laparoscopic myomectomy (RALM) offers a minimally invasive, uterus-preserving approach. A 34-year old woman with no history of sexual activity presented with a large, painless abdominal mass without menstrual abnormalities. Magnetic resonance imaging demonstrated multiple giant uterine leiomyomas and early right-sided hydronephrosis. RALM removed approximately 3.2 kg of histologically confirmed leiomyomatous tissue. Uterine artery clippling was not performed as retroperitoneal access was limited. Estimated blood loss was 2,000 mL, requiring three units of packed blood cells. Postopertive care including two days in the highcare unit and spontaneously resolving ileus. The patient was discharged in stable condition on day nine. This case demontrates the feasilibity of RALM for selected patients with giant leiomyomas while preserving uterus. However, substantial blood loss and postoperative ileus highlighted the importance of careful patient selection, surgical planning and counselling.