Robotic-assisted total hysterectomy with port hopping for giant uterine fibroids associated with umbilical herniaRobotic-assisted total hysterectomy with port hopping for giant uterine fibroids associated with umbilical hernia

Abstract

　This case was complicated by an umbilical hernia, probably due to a large 2,705 g uterine fibroid, which proved difficult to manage with a uterine manipulator. We successfully performed a robot-assisted total hysterectomy and hernia repair using an economical, aesthetically pleasing, and manpower-saving robotic surgical technique (using only four da Vinci ports without an assistant port and utilizing an endoscope and forceps port hopping).

　The operative time was 339 minutes (console time 197 minutes), with 119 minutes dedicated to removing the uterus and a recorded blood loss of 500 ml. The patient was comfortably discharged on the fifth postoperative day. No recurrence and complication of the umbilical hernia has been reported one year after surgery.