Comparison of perioperative outcomes between standard laparoscopic and robot‐assisted approach in patients with rectosigmoid endometriosis

Raimondo, Diego; Alboni, Carlo; Orsini, Benedetta; Aru, Anna Chiara; Farulla, Antonino; Maletta, Manuela; Arena, Alessandro; Forno, Simona Del; Sampogna, Veronica; Mastronardi, Manuela; Petrillo, Marco; Seracchioli, Renato

doi:10.1111/aogs.14170

Cited by 15 publications

(31 citation statements)

References 20 publications

(53 reference statements)

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“…Reviews, case reports and case series with less than 10 patients were excluded, obtaining 26 articles for the qualitative synthesis (Table 1,Ref. [19][20][21][22][23][24][25][26][27][28][29][30][31] ; Table 2, Ref. [17,[32][33][34][35][36][37][38][39][40][41][42][43]).…”

Section: Methodsmentioning

confidence: 99%

“…A prospective cohort study by Le Gac et al [23] reports similar perioperative outcomes in 23 patients treated with RALS and 25 patients treated by conventional laparoscopy except for longer operative time in RALS group, defining RALS an adequate alternative to laparoscopy for the treatment of deep endometriosis. In a prospective multicenter observational study, Raimondo et al [24] compared perioperative outcomes and endometriosis-related symptoms trend in 44 patients treated for rectosigmoid endometriosis, with 22 patients undergoing RALS and 22 patients undergoing conventional laparoscopy. Operative room occupancy time was the only parameter which differed between the two groups but operative time (from skin incision to suture), blood loss, complication rate and hospital stay was comparable.…”

Section: Deep Endometriosismentioning

confidence: 99%

“…One other study investigated the effect of surgery for deep endometriosis, comparing conventional laparoscopy with robot-assisted laparoscopy [24]. Endometriosisrelated symptoms were pre-and postoperatively evaluated with an 11-item Visual Analogue Scale (VAS).…”

Section: Quality Of Lifementioning

confidence: 99%

See 2 more Smart Citations

Robotic Surgery and Deep Infiltrating Endometriosis Treatment: The State of Art

Alboni¹,

Mattos²,

Marca³

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Objective: Surgical treatment of endometriosis, when indicated, has demonstrated to be effective in reducing painful symptoms and improve quality of life of patients affected with endometriosis. The minimally invasive approach via laparoscopy is the preferred method when compared with laparotomy but in the last two decades another minimally invasive approach has become available, the robotically assisted laparoscopic surgery. Robotic technology is widely used in different surgical branches, such as general surgery and urology. Moreover, the use of robotic surgery is already accepted for different gynecological procedures either for benign and for oncological diseases. The advantages of robotic surgery such as improve dexterity of movements, avoided tremor, increased magnification of 3dimensional vision seem strategic in the context of a complex surgery as is deep endometriosis eradication. However, to date there is no unanimous consensus on whether robotically assisted procedures are a valid and safe alternative to laparoscopy in the treatment of endometriosis. Mechanism: In this narrative review we analyze the available literature assessesing the robotic treatment of all types of endometriosis and specifically deep infiltrating endometriosis, compared to the outcomes of conventional laparoscopy. Findings in Brief: Indeed, the evidence of safety and effectiveness of robotically assisted laparoscopy in endometriosis treatment is strong and almost unanimous. There is no clear superiority of one approach to the other but robotic-related advantages and future prospective are promising to be able to improve operative outcomes, reduce surgeon's fatigue and provide a technology easy to implement with a fast learning curve. Conclusions: Robotic technology applied to laparoscopy in the treatment of endometriosis could be seen as an effective and safe alternative to the conventional laparoscopic treatment.

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Section: Methodsmentioning

confidence: 99%

Section: Deep Endometriosismentioning

confidence: 99%

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Robotic Surgery and Deep Infiltrating Endometriosis Treatment: The State of Art

Alboni¹,

Mattos²,

Marca³

et al. 2023

Clin. Exp. Obstet. Gynecol.

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“…It is worth to notice that the most encouraging result has been observed in advanced stage endometriosis, a procedure that requires demanding surgical effort (5,(23)(24)(25). In previous published case series (26)(27)(28), RAL has demonstrated a high success rate in patients with stage IV endometriosis with colorectal involvement.…”

Section: Robotic-assisted Laparoscopy and Endometriosismentioning

confidence: 98%

“…Raimondo et al (23) compared perioperative outcome in a multicentric prospective study of 44 cases with stage III to IV endometriosis eradication performed by two surgeons proficient in both LPS and RAL. Data showed no significant difference between the two groups regarding operative time, confirming the importance of an adequate training of the operator approach to this innovative surgical technique.…”

Section: Robotic-assisted Laparoscopy and Endometriosismentioning

confidence: 99%

New technologies in the surgical management of endometriosis

Massimello

Sardo²,

Bifulco³

et al. 2023

abtpn

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Introduction: Endometriosis is a very common disease that affects up to 10% of the female population. Although medical therapy represents the first-line treatment for endometriosis, it does not always manage to control symptoms. Laparoscopy represents the standard surgical treatment in endometriosis. Robotic-assisted laparoscopy is an innovative mini-invasive surgical technique. Its application in gynecological surgery and in endometriosis has increased in the last decade. Our purpose is to offer an overview of the role of robotic-assisted laparoscopy in the surgical treatment of endometriosis. Methods: We evaluated studies dealing with the new technique in surgery for endometriosis with a focus on robotic surgery. We performed a compressive literature research on PubMed and the Cochrane Library in December 2022. Expert opinion: Robotic-assisted surgery is a feasible and safe approach to endometriosis surgery and is superimposable to laparoscopy in terms of complication rate, blood loss, hospitalization, and long-term improvement of symptoms. The effect of robotic-assisted surgery on operative time is still contradictory and needs to be further investigated. Robotic-assisted laparoscopic surgery can provide particular benefit in the management of women with severe endometriosis secondary to its advantage in surgical precision and ergonomics. Indocyanine green fluorescence angiography could be useful to assist in the vascularization of ureters and bowel anastomosis, to prevent postoperative complication and leakage.

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Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework

Ong,

Shulman,

Nugraha

et al. 2024

Int J Colorectal Dis

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Aims This review aims to evaluate the feasibility of robot-assisted laparoscopic surgery (RALS) as an alternative to standard laparoscopic surgery (SLS) for the treatment of bowel deep-infiltrative endometriosis. Additionally, it aims to provide guidance for future study design, by gaining insight into the current state of research, in accordance with the IDEAL framework. Method A systematic review was conducted to identify relevant studies on RALS for bowel deep infiltrating endometriosis in Medline, Embase, Cochrane Library and PubMed databases up to August 2023 and reported in keeping with PRISMA guidelines. The study was registered with PROSPERO Registration: CRD42022308611 Results Eleven primary studies were identified, encompassing 364 RALS patients and 83 SLS patients, from which surgical details, operative and postoperative outcomes were extracted. In the RALS group, mean operating time was longer (235 ± 112 min) than in the standard laparoscopy group (171 ± 76 min) (p < 0.01). Patients in the RALS group experienced a shorter hospital stay (5.3 ± 3.5 days vs. 7.3 ± 4.1 days) (p < 0.01), and appeared to have fewer postoperative complications compared to standard laparoscopy. Research evidence for RALS in bowel DE is at an IDEAL Stage 2B of development. Conclusion RALS is a safe and feasible alternative to standard laparoscopy for bowel endometriosis treatment, with a shorter overall length of stay despite longer operating times. Further robust randomized trials recommended to delineate other potential advantages of RALS.

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Comparison of perioperative outcomes between standard laparoscopic and robot‐assisted approach in patients with rectosigmoid endometriosis

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 15 publications

References 20 publications

Robotic Surgery and Deep Infiltrating Endometriosis Treatment: The State of Art

Robotic Surgery and Deep Infiltrating Endometriosis Treatment: The State of Art

New technologies in the surgical management of endometriosis

Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework

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