Outcomes of robotic and laparoscopic surgery for benign gynaecological disease: a systematic review
Affiliations
Affiliations
- Saint Joseph University, Beirut, Lebanon.
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy.
- 2nd Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- Department of Obstetrics and Gynecology, Farwanya Hospital, MOH, Farwanya, Kuwait.
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan.
- Department of Obstetrics and Gynecology, Lebanese American University, Beirut, Lebanon.
Abstract
Benign gynaecological diseases are usually treated with minimally invasive approaches. Robotic surgery seems an alternative to laparoscopic surgery. No definitive conclusions have yet been made regarding comparison of robotic versus laparoscopic surgery for benign diseases. In this scenario, we performed a systematic review in order to assess the advantages and disadvantages of laparoscopy versus robotic surgery and conclude whether laparoscopy should be replaced by robotic surgery for the treatment of benign gynaecological conditions, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement. We included 64 studies: no significant difference was observed regarding overall complication rate; no significant benefit of robotic approach was demonstrated regarding length of hospital stay and conversion to laparotomy; furthermore, robotic surgery is more easily used by non-experienced surgeons, while it is more expensive and characterised by longer operative time. In conclusion, current evidence indicates neither statistically significant nor clinically meaningful differences in surgical outcomes between robotic and laparoscopic surgeries for benign gynaecological diseases. Impact statement
What is already known on this subject? Benign gynaecological diseases are usually treated with minimally invasive approaches. Nevertheless, no definitive conclusions have yet been made regarding comparison of robotic versus laparoscopic surgery for benign diseases.
What do the results of this study add? No significant difference was observed regarding overall complication rate; no significant benefit of robotic approach was demonstrated regarding length of hospital stay and conversion to laparotomy; furthermore, robotic surgery is more easily used by non-experienced surgeon, while it is more expensive and characterised by longer operative time.What are the implications of these findings for clinical practice and/or further research? Robotic surgery should not replace laparoscopy for the treatment of benign gynaecological conditions; in addition, gynaecologic surgeon should offer robotic surgery for benign diseases only after a proper counselling and a balanced decision-making process involving the patient.
Keywords: Laparoscopy; benign gynaecological diseases; robotic surgery; surgical outcomes; systematic review.
Similar articles
Robotic surgery for benign gynaecological disease.
Liu H, Lu D, Wang L, Shi G, Song H, Clarke J.Cochrane Database Syst Rev. 2012 Feb 15;(2):CD008978. doi: 10.1002/14651858.CD008978.pub2.PMID: 22336855 Updated. Review.
Robot-assisted surgery in gynaecology.
Lawrie TA, Liu H, Lu D, Dowswell T, Song H, Wang L, Shi G.Cochrane Database Syst Rev. 2019 Apr 15;4(4):CD011422. doi: 10.1002/14651858.CD011422.pub2.PMID: 30985921 Free PMC article.
Milone M, Manigrasso M, Vertaldi S, Velotti N, Aprea G, Maione F, Gennarelli N, De Simone G, De Conno B, Pesce M, Sarnelli G, De Palma GD.Dis Esophagus. 2019 Dec 13;32(10):1-8. doi: 10.1093/dote/doz062.PMID: 31274153
[No authors listed]Ann Clin Lab Sci. 2022 May;52(3):511-525.PMID: 35777803 No abstract available.
Robotic versus laparoscopic adrenalectomy: a systematic review and meta-analysis.
Brandao LF, Autorino R, Laydner H, Haber GP, Ouzaid I, De Sio M, Perdonà S, Stein RJ, Porpiglia F, Kaouk JH.Eur Urol. 2014 Jun;65(6):1154-61. doi: 10.1016/j.eururo.2013.09.021. Epub 2013 Sep 20.PMID: 24079955 Review.
References
https://pubmed.ncbi.nlm.nih.gov/