Robot-assisted laparoscopy for deep infiltrating endometriosis: a retrospective French multicentric study (2008-2019) using the Society of European Robotic Gynecological Surgery endometriosis database

Objective This study aimed at assessing perioperative results of robot-assisted laparoscopy (RAL) in the context of deep infiltrating endometriosis (DIE).

This retrospective French multicentric study included all patients with DIE who underwent surgical treatment managed by RAL (Da Vinci® System). From November 2008 to June 2019, patients were included in a single European database, in Robotic Assisted Laparoscopic Gynecologic Surgery, with Society of European Robotic Gynecological Surgery collaboration. Patients had different DIE sites as follows: gynecological, urological, or digestive, or combinations of these. Surgical procedures and perioperative complications were evaluated. To assess complications, patients were divided into the following four groups according to surgical procedure and DIE site: gynecological only; gynecological and urological; gynecological and digestive; and gynecological, urological, and digestive.

A total of 460 patients treated at one of eight health-care facilities from November 2008 to June 2019 were included. Median operative time was 245 min (IQR 186–320), surgeon console time was 138 ± 75 min and estimated blood loss was 70.0 mL ± 107 mL. Among this patient sample, 42.1% had a multidisciplinary surgical approach with a digestive or urology surgeon in addition to gynecology surgeon (25.5% and 16.6% of cases, respectively). Among those with intraoperative complications (n = 25, 5.4%) were primarily conversion to laparotomy (n = 6, 2.0%), transfusion (n = 2, 0.6%), and organ wounds (n = 8, 1.7%). Overall, 5.6% had severe postoperative complications (Clavien–Dindo classification ≥ Grade 3).

This is among the largest published series addressing RAL for DIE. Interest in this procedure appears promising, with no observed increases in blood loss or in peri- or post-operative complications. DIE laparoscopic surgery can require complex surgical procedures performed by multidisciplinary surgical teams. Thus, it may be one of the best candidates for RAL within gynecology surgery. Similar content being viewed by others

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The authors thank the Data Management and Analysis Centre (DMAC) at the Paoli Calmettes Institute (IPC) in Marseille (France) and the Society of European Robotic Gynecological Surgery (SERGS) for accessing and using data from the European Robotic Datase (EUROD). Author information Authors and Affiliations Contributions TG and PC: investigators of the project ES and CP: data collection ES, CP, EB, LG: had participated in preparing the bibliography. JB, EB, FG, TH, YK, VL, BM, SM, CT, FV, TG, PC: the surgeons who participated in surgeries. Corresponding author Ethics declarations Conflict of interest The authors have no conflict of interest. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Saget, E., Peschot, C., Bonin, L. et al. Robot-assisted laparoscopy for deep infiltrating endometriosis: a retrospective French multicentric study (2008–2019) using the Society of European Robotic Gynecological Surgery endometriosis database. Arch Gynecol Obstet 305, 1105–1113 (2022). https://doi.org/10.1007/s00404-022-06414-6 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-022-06414-6