Robotic Surgery and Deep Infiltrating Endometriosis Treatment: The State of Art

Carlo Alboni, Ludovica Camacho Mattos, Antonio La Marca, Diego Raimondo, Paolo Casadio, Renato Seracchioli, Giorgia Gaia
In: Clinical and Experimental Obstetrics & Gynecology · 2023 · vol. 50(1) · doi:10.31083/j.ceog5001013 · W4315853531
article OA: gold CC0 ⤵ 4 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review analyzes literature comparing robotic-assisted and conventional laparoscopic surgery for endometriosis, finding robotic surgery to be a safe and effective alternative with promising future applications.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This narrative review assesses the literature (PubMed, Cochrane, Embase; April 2005 to March 2022) on robotic-assisted laparoscopic surgery (RALS) for all stages of endometriosis, with emphasis on deep infiltrating endometriosis (DIE), comparing feasibility, safety, and outcomes versus conventional laparoscopy. Across included studies, robotic approaches are reported to be generally safe and feasible, with evidence from the multicenter randomized LAROSE trial showing no differences between RALS and laparoscopy in operative time, blood loss, complication rates (adjusted for procedures), or histologic confirmation, while other cohorts report low postoperative complication rates and similar complication profiles to conventional approaches. The review notes the lack of unanimous consensus and the limited scope/heterogeneity of the evidence for definitive superiority, including exclusions in key trials such as cases requiring bowel resection or ureteral reanastomosis. This paper is centrally about endometriosis — it specifically reviews robotic surgery’s feasibility and safety for deep infiltrating endometriosis and compares RALS with conventional laparoscopy.

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Abstract

Objective: Surgical treatment of endometriosis, when indicated, has demonstrated to be effective in reducing painful symptoms and improve quality of life of patients affected with endometriosis. The minimally invasive approach via laparoscopy is the preferred method when compared with laparotomy but in the last two decades another minimally invasive approach has become available, the robotically assisted laparoscopic surgery. Robotic technology is widely used in different surgical branches, such as general surgery and urology. Moreover, the use of robotic surgery is already accepted for different gynecological procedures either for benign and for oncological diseases. The advantages of robotic surgery such as improve dexterity of movements, avoided tremor, increased magnification of 3-dimensional vision seem strategic in the context of a complex surgery as is deep endometriosis eradication. However, to date there is no unanimous consensus on whether robotically assisted procedures are a valid and safe alternative to laparoscopy in the treatment of endometriosis. Mechanism: In this narrative review we analyze the available literature assessesing the robotic treatment of all types of endometriosis and specifically deep infiltrating endometriosis, compared to the outcomes of conventional laparoscopy. Findings in Brief: Indeed, the evidence of safety and effectiveness of robotically assisted laparoscopy in endometriosis treatment is strong and almost unanimous. There is no clear superiority of one approach to the other but robotic-related advantages and future prospective are promising to be able to improve operative outcomes, reduce surgeon’s fatigue and provide a technology easy to implement with a fast learning curve. Conclusions: Robotic technology applied to laparoscopy in the treatment of endometriosis could be seen as an effective and safe alternative to the conventional laparoscopic treatment.

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endometriosisdie_deep_infiltrating

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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