Robotic assisted versus laparoscopic surgery for deep endometriosis: a meta-analysis of current evidence.


Journal

Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401

Informations de publication

Date de publication:
16 May 2024
Historique:
received: 19 02 2024
accepted: 14 04 2024
medline: 16 5 2024
pubmed: 16 5 2024
entrez: 16 5 2024
Statut: epublish

Résumé

Endometriosis is a benign inflammatory onco-mimetic disease affecting 10-15% of women in the world. When it is refractory to medical treatments, surgery may be required. Usually, laparoscopy is the preferred approach, but robotic surgery has gained popularity in the last 15 years. This study aims to evaluate the safety and efficacy of robotic-assisted laparoscopic surgery (RAS) versus conventional laparoscopic surgery (LPS) in the treatment of endometriosis. This study adheres to PRISMA guidelines and is registered with PROSPERO. Studies reporting perioperative data comparing RAS and LPS surgery in patients with endometriosis querying PubMed, Google Scholar and ClinicalTrials.gov were included in the analysis. The Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2) was used for the quality assessment of the selected articles. Fourteen studies were identified, including 2709 patients with endometriosis stage I-IV for the meta-analysis. There were no significant differences between RAS and LPS in terms of intraoperative and postoperative complications, conversion rate and estimated blood loss. However, patients in the RAS group have a longer operative time (p < 0.0001) and longer hospital stay (p = 0.020) than those in the laparoscopic group. Robotic surgery is not inferior to laparoscopy in patients with endometriosis in terms of surgical outcomes; however, RAS requires longer operative times and longer hospital stay. The benefits of robotic surgery should be sought in the easiest potential integration of robotic platforms with new technologies. Prospective studies comparing laparoscopy to the new robotic systems are desirable for greater robustness of scientific evidence.

Identifiants

pubmed: 38753180
doi: 10.1007/s11701-024-01954-2
pii: 10.1007/s11701-024-01954-2
doi:

Types de publication

Journal Article Meta-Analysis Comparative Study Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

212

Informations de copyright

© 2024. The Author(s).

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Auteurs

Matteo Pavone (M)

UOC Ginecologia Oncologica, Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. matteo.pavone@guest.policlinicogemelli.it.
Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France. matteo.pavone@guest.policlinicogemelli.it.
Research Institute against Digestive Cancer, IRCAD, Strasbourg, France. matteo.pavone@guest.policlinicogemelli.it.

Alessandro Baroni (A)

UOC Ginecologia Oncologica, Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. baronial.ab@gmail.com.

Federica Campolo (F)

UOC Ginecologia Oncologica, Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.

Marta Goglia (M)

Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.

Diego Raimondo (D)

Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

Antonella Carcagnì (A)

Facility of Epidemiology and Biostatistics - Gemelli Generator, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.

Cherif Akladios (C)

Department of Gynecologic Surgery, University Hospitals of Strasbourg, Strasbourg, France.

Jacques Marescaux (J)

Research Institute against Digestive Cancer, IRCAD, Strasbourg, France.

Francesco Fanfani (F)

UOC Ginecologia Oncologica, Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Giovanni Scambia (G)

UOC Ginecologia Oncologica, Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Manuel Maria Ianieri (MM)

UOC Ginecologia Oncologica, Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy.

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