Postoperative opioid use for patients with chronic pelvic pain undergoing robotic surgery for resection of endometriosis

Delgado, Stephanie; Koythong, Tamisa; Turrentine, Mark A.; Sangi‐Haghpeykar, Haleh; Guan, Xiaoming

doi:10.1007/s11701-021-01259-8

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…17 and use over two times as many opioids postoperatively when compared to patients without endometriosis who underwent comparable robotic-assisted surgery. 29 In our study, patients with significant preoperative pelvic pain had statistically significant higher pain scales after the third week, compared with patients without preoperative pain. Therefore, providers should be aware of patients with history of preoperative pain or endometriosis, as this will help guide preoperative counselling and patient postoperative expectations in the recovery process.…”

Section: Discussionsupporting

confidence: 45%

“…reported because 50.00% of our patients had resection of endometriosis at the time of hysterectomy. Patients who underwent robotic‐assisted surgery for endometriosis have higher postoperative pain scores and use over two times as many opioids postoperatively when compared to patients without endometriosis who underwent comparable robotic‐assisted surgery 29 . In our study, patients with significant preoperative pelvic pain had statistically significant higher pain scales after the third week, compared with patients without preoperative pain.…”

Section: Discussionmentioning

confidence: 47%

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Evaluation of the learning curve and safety outcomes in robotic assisted vaginal natural orifice transluminal endoscopic hysterectomy: A case series of 84 patients

Liu

Tan

Thigpen

et al. 2022

Robotics Computer Surgery

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Background: To explore the learning curve and safety outcomes of robotic assisted transvaginal natural orifice transluminal endoscopic surgery (R-vNOTES) for hysterectomy in benign gynaecological diseases. Methods:A retrospective chart review of all patients undergoing R-vNOTES hysterectomy for benign gynaecological disease from 2019 to 2021.Setting: An academic tertiary care university hospital in Houston, TX, USA.Results: 84 patients were identified that met the study requirements. The mean hysterectomy time was 77.27 � 2.89 min. The median additional operation time was 63 (8-206) min. There were two conversions to robotic assisted single incision laparoscopy. Thirteen (15.48%) patients had an associated complication. Analysis of the learning curve suggests plateauing of hysterectomy time at approximately 10 cases and time for robot docking and port placement after 10-20 cases.Conclusion: R-vNOTES is a safe and effective route for hysterectomy. For a surgeon with experience in laparoscopic single site surgery and abdominal robotic surgery, they need to perform 10 cases of R-vNOTES hysterectomy and 10-20 cases in port placement and robotic docking to achieve proficiency.

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Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 47%

Evaluation of the learning curve and safety outcomes in robotic assisted vaginal natural orifice transluminal endoscopic hysterectomy: A case series of 84 patients

Liu

Tan

Thigpen

et al. 2022

Robotics Computer Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Noteworthy short‐term complications in the postoperative period for our patients in this case series include challenges in pain control for 4 patients, potentially linked to a heightened tolerance to opioid‐based analgesics given each patient's history of chronic pelvic pain. We have demonstrated that patients with chronic pelvic pain undergoing robotic resection of endometriosis typically require higher amounts of opioids in the postoperative period compared with patients without chronic pelvic pain 29 . Additionally, 3 patients experienced immediate postoperative urinary retention, necessitating Foley catheter placement.…”

Section: Discussionmentioning

confidence: 99%

“…We have demonstrated that patients with chronic pelvic pain undergoing robotic resection of endometriosis typically require higher amounts of opioids in the postoperative period compared with patients without chronic pelvic pain. 29 Additionally, 3 patients experienced immediate postoperative urinary retention, necessitating Foley catheter placement. We typically plan for the same day discharge from the hospital after surgery for appropriately selected patients without contraindications to do so.…”

Section: Discussionmentioning

confidence: 99%

Exploring the feasibility of indocyanine green fluorescence for intraoperative ureteral visualisation in robotic transvaginal natural orifice transluminal endoscopy surgery during endometriosis resection

Delgadillo Chabolla,

Alpuing Radilla,

Koythong

et al. 2024

Robotics Computer Surgery

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BackgroundTo assess the feasibility of use of indocyanine green (ICG) in identifying and minimising urinary tract injury during surgical resection of endometriosis through robotic transvaginal natural orifice transluminal endoscopy surgery (RvNOTES).MethodsWe conducted a retrospective case series in two academic tertiary care hospitals. We examined 53 patients who underwent RvNOTES hysterectomy with planned endometriosis resection.ResultsThe study involved 53 patients undergoing RvNOTES with ICG fluorescence for endometriosis resection. Mean patient age was 37.98 ± 6.65 years. Operative time averaged 181.32 ± 53.94 min, with estimated blood loss at 45.57 ± 33.62 mL. Postoperative stay averaged 0.23 ± 0.47 days. No ICG‐related complications occurred.ConclusionNo complications occurred with ICG fluorescence in RvNOTES. It appears to be a safe option for ureteral localisation and preservation. ICG fluorescence is widely used in diverse medical specialities for identifying ureters during complex surgeries. Larger studies are needed to firmly establish its advantages in intraoperative ureteral visualisation during RvNOTES for deep infiltrative endometriosis.

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“…[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]). PRISMA guidelines were followed during the selection process [44,45] (Fig.…”

Section: Methodsmentioning

confidence: 99%

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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Postoperative opioid use for patients with chronic pelvic pain undergoing robotic surgery for resection of endometriosis

Cited by 6 publications

References 19 publications

Evaluation of the learning curve and safety outcomes in robotic assisted vaginal natural orifice transluminal endoscopic hysterectomy: A case series of 84 patients

Evaluation of the learning curve and safety outcomes in robotic assisted vaginal natural orifice transluminal endoscopic hysterectomy: A case series of 84 patients

Exploring the feasibility of indocyanine green fluorescence for intraoperative ureteral visualisation in robotic transvaginal natural orifice transluminal endoscopy surgery during endometriosis resection

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

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