Robot-assisted laparoscopy does not have demonstrable advantages over
conventional laparoscopy in endometriosis surgery: a systematic review
and meta-analysis
Abstract
Background: Endometriosis is a chronic condition affecting
6-10% of women of reproductive age, with endometriosis-related pain and
infertility being the leading symptoms. Currently, the gold standard
treatment approach to surgery is conventional laparoscopy (CL); however,
the increasing availability of robot-assisted surgery is projected as a
competitor of CL. This study aimed to compare the perioperative outcomes
of robot-assisted laparoscopy (RAL) and CL in endometriosis surgery.
Objectives: We aimed to compare the effectiveness and safety of
these two procedures. Methods: A systematic search was
conducted in three medical databases. Studies investigating different
perioperative outcomes of endometriosis-related surgeries were included.
Results are presented as odds ratios (OR) or mean differences (MD) with
95% confidence intervals (CI). Results: Our search yielded
2,014 records, of which 13 were eligible for data extraction. No
significant differences were detected between the CL and RAL groups in
terms of intraoperative complications (OR=1.07, CI:0.43-2.63),
postoperative complications (OR=1.3, CI:0.73-2.32), number of
conversions to open surgery (OR=1.34, CI:0.76-2.37), length of hospital
stays (MD=0.12, CI:0.33-0.57), blood loss (MD=16.73, CI:4.18-37.63) or
number of rehospitalizations (OR= 0.95, CI:0.13-6.75). In terms of
operative times (MD=28.09 minutes, CI:11.59-44.59) and operating room
times (MD=51.39 minutes, CI:15.07-87.72;), the RAL technique remained
inferior. Conclusions: RAL does not have statistically
demonstrable advantages over CL in terms of perioperative outcomes for
endometriosis-related surgery.