Robotic Hybrid Technique in Rectal Surgery for Deep Pelvic Endometriosis

Abstract

Deep pelvic endometriosis is a benign condition but may have substantial impact on quality of life due to severe pelvic symptoms. We believe that robotic-assisted laparoscopic colorectal resection is a feasible and relatively safe procedure in the context of close collaboration between gynecologists and surgeons for treatment of deep pelvic endometriosis with intestinal involvement, with low rates of complications and significant improvement of intestinal symptoms.

‘Money for nothing’. The role of robotic-assisted laparoscopy for the treatment of endometriosis

“…included women operated with RAL only (Abo et al, 2016;Bedaiwy et al, 2013;Brudie et al, 2012;Collinet et al, 2014;Ercoli et al, 2012;Lim et al, 2011;Morelli et al, 2016;Neme et al, 2013;Nezhat et al, 2011;Pellegrino et al, 2015;Siesto et al, 2014), whereas six studies were comparative, i.e. compared two series of women operated with RAL and SL (Cassini et al, 2014;Dulemba et al, 2013;Magrina et al, 2015;Nezhat et al, 2010Nezhat et al, , 2015Nezhat and Sirota, 2014). None of these comparative studies was a randomized trial.…”

“…Operating time was significantly longer in the RAL group compared with the SL group in five studies (Cassini et al, 2014;Magrina et al, 2015;Nezhat et al, 2010Nezhat et al, , 2015Nezhat and Sirota, 2014), and comparable between RAL and SL groups in one study (Dulemba et al, 2013). However, in one study, the longer operating time was explained by the higher number of procedures and more radical operations in the RAL group.…”

“…In another study, hospital stay was longer in the RAL group at univariate analysis, but comparable between RAL and SL at multivariate analysis (Magrina et al, 2015). Hospital stay was comparable between RAL and SL groups in two studies (Cassini et al, 2014;Nezhat and Sirota, 2014), although in one of these studies (Cassini et al, 2014) the data for the SL group were not reported.…”

“…In each of the remaining five studies, the rate of hysterectomy in the RAL versus the SL group was 25% versus 21% , 0% versus 0% (Cassini et al, 2014;Dulemba et al, 2013;Nezhat et al, 2015) and not reported (Nezhat et al, 2010), respectively. In one study (Cassini et al, 2014), all patients underwent colorectal resection. The characteristics of the patients and the perioperative data of the six comparative studies are reported in Table 4.…”

“…In four studies, follow-up time was 42 days or less (Dulemba et al, 2013;Magrina et al, 2015;Nezhat et al, 2010;Nezhat and Sirota, 2014), in one study follow up was not reported (Nezhat et al, 2015). In one study, a 6-month follow up evaluation was reported only for the RAL group, with a significant reduction of pain symptoms compared with pre-operative assessment and a pregnancy rate of 2/19 (10%) (Cassini et al, 2014).…”