Outcomes of discoid excision and segmental resection for colorectal endometriosis: robotic versus conventional laparoscopy

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Robotic surgery for colorectal endometriosis discoid excision and resection showed longer operative times but reduced hospital stay and persistent voiding dysfunction compared to conventional laparoscopy.

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This retrospective cohort study compared surgical outcomes of robotic versus conventional laparoscopy in 152 consecutive patients with colorectal endometriosis undergoing discoid excision or segmental colorectal resection between 2019 and 2023. Robotic surgery was associated with longer total operating time and longer surgical room occupancy, while intraoperative blood loss and the incidence of intra- and postoperative complications (Clavien–Dindo) were similar between groups. Mean hospital stay was slightly shorter after robotic surgery, and persistent voiding dysfunction occurred more often with conventional laparoscopy, including after segmental resection. The authors did not generate or analyze datasets beyond the reported retrospective cohort, and the study’s design is subject to selection bias inherent to nonrandomized comparisons. This paper is centrally about endometriosis — it evaluates robotic versus conventional laparoscopic approaches for discoid excision and segmental resection in colorectal endometriosis.

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Abstract

Surgery for deep endometriosis with colorectal involvement is an option after medical treatment failure. Over the past decade, robotic laparoscopy has emerged as an alternative to conventional laparoscopy. We aimed to evaluate surgical outcomes of robotic versus conventional laparoscopy for discoid excision and segmental resection. From 2019 to 2023, we conducted a retrospective cohort study of 152 consecutive patients with colorectal endometriosis who underwent robotic or conventional laparoscopy for discoid excision and colorectal resection. Ninety of the patients 152 underwent robotic surgery and 62 conventional laparoscopy. The mean total surgical room occupancy and operating times were longer in the robotic group: 270 ± 81 min vs 240 ± 79 min, p = 0.010, and 216 ± 78 min vs 190 ± 76, p = 0.027, respectively. The mean intraoperative blood loss, and the incidence of intra- and postoperative complications (according to Clavien–Dindo classification) were similar in the two groups. The mean hospital stay was greater after conventional laparoscopy (8 ± 5 vs 7 ± 4 days; p = 0.03), and the rate of persistent voiding dysfunction was higher in the conventional group (9/11, 25% vs 2/11, 5%; p = 0.01). A higher incidence of persistent voiding dysfunction was also observed after segmental resection by conventional laparoscopy (25% vs 4.8%, p = 0.01). Our results support the use of robotic surgery as an alternative to conventional laparoscopy for discoid excision and segmental resection for colorectal endometriosis. Similar content being viewed by others Data availability No datasets were generated or analysed during the current study.

References

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Ethical approval Institutional review board approval was obtained and all patients gave their written informed consent to participate in the study (CEROG 2012-GYN-10-03). Consent to participate Information consent was obtained from all individual participants included in the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Crestani, A., Le Gac, M., de Labrouhe, É. et al. Outcomes of discoid excision and segmental resection for colorectal endometriosis: robotic versus conventional laparoscopy. J Robotic Surg 18, 87 (2024). https://doi.org/10.1007/s11701-024-01854-5 Received: Accepted: Published: Version of record: DOI: https://doi.org/10.1007/s11701-024-01854-5

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mesh:D004715endometriosis

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Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms

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