Changes in anti-Müllerian hormone values for ovarian reserve after minimally invasive benign ovarian cystectomy: Comparison of the Da Vinci robotic systems (Xi and SP) and the laparoscopic system

Abstract

Abstract Objective To investigate the impact on the ovarian reserve after minimally invasive ovarian cystectomy using two platforms, the Da Vinci robotic system (Xi and SP) and the laparoscopic system. Materials and methods Patients underwent laparoscopic or Da Vinci robotic (Xi or SP) ovarian cystectomy for benign ovarian cysts between January 1, 2018, and December 31, 2022 at Guro Hospital, Korea University Medical center. We measured the change of AMH values(%) = [(postAMH − preAMH)] × 100 / preAMH. Main Results No significant differences in preoperative age, cyst size, estimated blood loss during surgery, hemoglobin drop, length of hospital stay, adhesion detachment rate and cyst rupture rate were observed. However, the operative time was significantly shorter in the laparoscopic group than that in the robotic group (67.78±30.58 min vs. 105.17±38.87 min, p<0.001) The mean preAMH and postAMH were significantly higher with the Da Vinci robotic group than with the laparoscopic group (preAMH: 5.89±4.81 ng/mL vs. 4.01±3.59 ng/mL, p=0.02, postAMH: 4.36±3.31 ng/mL vs. 3.08±2.60 ng/mL, p=0.02). However, the mean ΔAMH was not significantly different between two groups. ΔAMH also did not demonstrate significant differences among the three groups; laparoscopic, Xi and SP robotic. Even in the patient groups with preAMH < 2 and diagnosed with endometriosis, the ΔAMH did not show significant differences between the laparoscopic and robotic groups. Conclusion Although the Da Vinci robotic system requires a longer time for performing a benign ovarian cystectomy compared to laparoscopic surgery, it is an effective and minimally invasive method for preserving ovarian function.