Retrospective analysis of robot-assisted versus standard laparoscopy in the treatment of pelvic pain indicative of endometriosis

John F Dulemba, Dulemba JF, John Dulemba, Pelzel C, Cyndi Pelzel, Hubert HB, Helen B Hubert
Journal of robotic surgery · 2012 · vol. 7(2) , pp. 163–169 · doi:10.1007/s11701-012-0361-4 · PMID:27000908 · W2101179347
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

Robot-assisted laparoscopy showed comparable perioperative outcomes to standard laparoscopy for endometriosis, with similar pain improvement but higher endometriosis confirmation rates.

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This retrospective single-surgeon study compared feasibility and perioperative outcomes of robot-assisted laparoscopic surgery versus standard CO2 laser laparoscopy for pelvic pain with suspected endometriosis, using the last 100 standard cases and the first 180 robot-assisted cases. The groups were comparable on factors including gravidity, BMI, prior endometriosis and surgery, AFS stage, and biopsy rates, and operative time, blood loss, and complication rates were low and similar between techniques. The main difference was a higher proportion of biopsies confirming endometriosis with robot-assisted surgery (80% vs 56.8%, p < 0.001), while most patients reported improved postoperative pain at first follow-up with no significant approach-related difference (85% vs 80%, p = 0.365). A major limitation is that the study’s retrospective design and short follow-up leave uncertainty about whether robotics yields better symptom resolution or fertility outcomes. This paper is centrally about endometriosis — it directly evaluates robot-assisted versus standard laparoscopy for pelvic pain indicative of endometriosis, including biopsy confirmation rates and postoperative pain outcomes.

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Abstract

We 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.
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Abstract

We 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. Similar content being viewed by others

References

Matalliotakis 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 Leibson CL, Good AE, Hass SL (2004) Incidence and characterization of diagnosed endometriosis in a geographically defined population. Fertil Steril 82:314–321 Wykes 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 Cramer DW, Missmer SA (2002) The epidemiology of endometriosis. Ann NY Acad Sci 955:11–22 Sinaii 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 Practice Committee American Society for Reproductive Medicine (2008) Treatment of pelvic pain associated with endometriosis. Fertil Steril 90(Suppl 3):S260–S269 Namnoum AB, Hickman TN, Goodman SB, Gehlbach DL, Rock JA (1995) Incidence of symptom recurrence after hysterectomy for endometriosis. Fertil Steril 64:898–902 Whiteman 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 Abbott 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 Sutton 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 Jacobson TZ, Duffy JM, Barlow D, Koninckx PR, Garry R (2009) Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database Syst Rev 4:CD001300 Chammas 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 Liu 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 Nezhat C, Saberi NS, Shahmohamady B, Nezhat F (2006) Robotic-assisted laparoscopy in gynecological surgery. JSLS 10:317–320 Nezhat 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 Swan K, Advincula AP (2011) Understanding the financial impact of robotics in gynecologic surgery. Clin Obstet Gynecol 54:449–457 Payne TN, Pitter MC (2011) Robotic-assisted surgery for the community gynecologist: can it be adopted? Clin Obstet Gynecol 54:391–411 Acknowledgments Dr. Dulemba is a proctor for Intuitive Surgical, Inc. and Dr. Hubert has served as a consulting epidemiologist to Intuitive Surgical, Inc. Conflict of interest None disclosed. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Dulemba, 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 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s11701-012-0361-4

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