{"paper_id":"aeac6156-37e5-4e02-802d-d3bab14aade2","body_text":"Abstract\nWe examined the feasibility of treating pelvic pain in patients with suspected endometriosis using robot-assisted laparoscopic techniques compared with CO2 laser laparoscopy, in a retrospective review from a single surgeon’s practice, including the last 100 standard laparoscopic (December 2004–September 2007) and the first 180 robot-assisted (July 2007–January 2010) surgeries to treat suspected endometriosis. Perioperative outcomes and postoperative pain were compared by technique. Patients in each group were comparable in gravidity, body mass index, prior endometriosis, prior abdominopelvic surgery, American Fertility Society stage, and biopsy rates. Operative time (77 vs. 72 min), blood loss (29 vs. 25 mL), and complication rates (1.1 vs. 0 %) in robot-assisted and standard laparoscopy were low and similar for both approaches. Differences were apparent in biopsies confirming endometriosis (80 % robot-assisted vs. 56.8 % traditional laparoscopy, p < 0.001). Most patients reported improved postoperative pain at the first follow-up visit with no differences between the surgical approaches (85 % vs. 80 %, p = 0.365). Perioperative outcomes with robot-assisted surgery were comparable to outcomes using CO2 laser laparoscopy. Further investigation is needed to ascertain whether robotics provides better visual acuity and excision of endometriosis, as suggested by these data, and if long-term resolution of symptoms and fertility outcomes differ by surgical approach.\nSimilar content being viewed by others\nReferences\nMatalliotakis IM, Cakmak H, Fragouli YG, Goumenou AG, Mahutte NG, Arici A (2008) Epidemiological characteristics in women with and without endometriosis in the Yale series. Arch Gynecol Obstet 277:389–393\nLeibson CL, Good AE, Hass SL (2004) Incidence and characterization of diagnosed endometriosis in a geographically defined population. Fertil Steril 82:314–321\nWykes CB, Clark TJ, Khan KS (2004) Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic quantitative review. Br J Obstet Gynaecol 111:1204–1212\nCramer DW, Missmer SA (2002) The epidemiology of endometriosis. Ann NY Acad Sci 955:11–22\nSinaii N, Plumb K, Cotton L, Lambert A, Kennedy S, Zondervan K, Stratton P (2008) Differences in characteristics among 1,000 women with endometriosis based on extent of disease. Fertil Steril 89:538–545\nPractice Committee American Society for Reproductive Medicine (2008) Treatment of pelvic pain associated with endometriosis. Fertil Steril 90(Suppl 3):S260–S269\nNamnoum AB, Hickman TN, Goodman SB, Gehlbach DL, Rock JA (1995) Incidence of symptom recurrence after hysterectomy for endometriosis. Fertil Steril 64:898–902\nWhiteman MK, Hillis SD, Jamieson DJ, Morrow B, Podgornik MN, Brett KM, Marchbanks PA (2008) Inpatient hysterectomy surveillance in the United States, 2000-2004. Am J Obstet Gynecol 198(34):e1–e7\nAbbott J, Hawe J, Hunter D, Holmes M, Finn P, Garry R (2004) Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril 82:878–884\nSutton C, Ewen SP, Whitelaw N, Haines P (1994) Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril 62:696–700\nJacobson TZ, Duffy JM, Barlow D, Koninckx PR, Garry R (2009) Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database Syst Rev 4:CD001300\nChammas MF, Kim FJ, Barbarino A, Hubert N, Feuillu B, Coissard A, Hubert J (2008) Asymptomatic rectal and bladder endometriosis: a case for robotic-assisted surgery. Can J Urol 15:4097–4100\nLiu C, Perisic D, Samadi D, Nezhat F (2008) Robot-assisted laparoscopic bladder resection for the treatment of infiltrating endometriosis. J Minim Invasive Gynecol 15:745–748\nNezhat C, Saberi NS, Shahmohamady B, Nezhat F (2006) Robotic-assisted laparoscopy in gynecological surgery. JSLS 10:317–320\nNezhat C, Lewis M, Kotikela S, Veeraswamy A, Saadat L, Hajhosseini B, Nezhat C (2010) Robotic versus standard laparoscopy for the treatment of endometriosis. Fertil Steril 94:2758–2760\nSwan K, Advincula AP (2011) Understanding the financial impact of robotics in gynecologic surgery. Clin Obstet Gynecol 54:449–457\nPayne TN, Pitter MC (2011) Robotic-assisted surgery for the community gynecologist: can it be adopted? Clin Obstet Gynecol 54:391–411\nAcknowledgments\nDr. Dulemba is a proctor for Intuitive Surgical, Inc. and Dr. Hubert has served as a consulting epidemiologist to Intuitive Surgical, Inc.\nConflict of interest\nNone disclosed.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nDulemba, J.F., Pelzel, C. & Hubert, H.B. Retrospective analysis of robot-assisted versus standard laparoscopy in the treatment of pelvic pain indicative of endometriosis. J Robotic Surg 7, 163–169 (2013). https://doi.org/10.1007/s11701-012-0361-4\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s11701-012-0361-4","source_license":"CC0","license_restricted":false}