LAUSR

Video Objective Describing a minimally invasive technique for a solitary intramural myomectomy. Setting A 28-year-old African American nulliparous woman presented with pelvic pressure and ultrasound evidence of a large posterior/fundal intramural fibroid measuring 6 cm. She had abnormal and heavy uterine bleeding that was refractory to medical therapy. Definitive surgical treatment was desired and thus a robotic approach was planned. Interventions Myomectomy of a solitary intramural uterine fibroid is performed robotically. Several surgical tips are utilized and described herein. Tip#1: horizontal incision; Tip#2: Utility of a tenaculum for traction; Tip#3: Electrosurgical coagulative dissection; Tip#4: Layered closure with a resorbable barbed suture. Conclusion Hemostatic horizontal incisions, traction with a tenaculum, coagulative dissection, and the utility of a barbed resorbable suture are all steps one can utilize for successful completion of a myomectomy via robotic route.