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

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.