Robot-assisted laparoscopy does not have demonstrable advantages over conventional laparoscopy in endometriosis surgery: a systematic review and meta-analysis

Sándor Valent, Ádám Csirzó, Dénes Péter Kovács, Anett Szabó, Péter Fehérvári, Árpád Jankó, Péter Hegyi, Péter Nyírády, Zoltán Sipos, Levente Sára, Nándor Ács, István Szabó
In: Authorea, Inc. · 2023 · doi:10.22541/au.168351487.71384228/v1 · W4375843260
review preprint OA: gold CC0
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Robot-assisted laparoscopy demonstrated no significant perioperative advantages over conventional laparoscopy for endometriosis surgery, with longer operative and operating room times.

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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.

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endometriosisinfertility

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