Robotic Surgery in Gynaecology: A Retrospective Evaluation of an Experience at a Single Centre

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This retrospective study evaluated 211 robotic gynecological surgeries, finding robot-assisted procedures safe and effective with no conversions to laparotomy for hysterectomies or myomectomies.

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This single-centre retrospective observational study evaluated outcomes of robotic-assisted gynecologic surgery performed by all surgeons using the Da Vinci Si™ system at a quaternary care center between 2015 and 2022. Across 211 cases (172 hysterectomies, 20 myomectomies, and 19 other benign gynecologic indications), the authors reported mean operative times of 113 minutes for hysterectomy and 129 minutes for myomectomy, with mean haemoglobin drops of 1.34 and 1.2 g/dl, respectively; no conversions to laparotomy were observed in either group, and complications and conversion rates were tracked as main outcomes. The paper’s limitations include its retrospective design and reliance on electronic medical record data from a single center, with descriptive statistical analysis rather than controlled comparisons. Relevance to endometriosis: the paper does not specifically discuss endometriosis or adenomyosis in its study population or outcomes, but it appears in a corpus via upstream keyword matching for robotic gynecologic surgery.

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Abstract

ObjectiveThe aim of this research was to assess the role of robotics and its outcome in gynaecology both in benign and malignant cases in a single centre and provide a critical evaluation of possible advantages of robot assisted surgeries from surgeons' point of view.DesignA single centre, retrospective observational study.PopulationAll women who underwent robotic gynaecological surgeries between 2015 and 2022.MethodsThe Da Vinci Si™ robotic system was used for these surgeries performed by all surgeons at our quaternary care centre, and data were acquired retrospectively through electronic medical records. Descriptive statistical analysis of data was done. Main outcome measures included operative time, estimated blood loss, hospital stay, complications and conversion rates in all cases. Age was analysed as a demographic data.OutcomeA total of 211 robotic cases were performed including 172 hysterectomies, 20 myomectomies and 19 cases for other gynaecological indications. The mean operating time or hysterectomy and myomectomy was 113 and 129 min, respectively, and haemoglobin drop was 1.34 and 1.2 g/dl, respectively. No conversions to laparotomy were observed in either of the groups. The surgeries for 19 benign gynaecological conditions included ovarian cystectomy, cesarean scar repair and chronic cornual ectopic.ConclusionRobotic surgical system helps accomplish several procedures with exceptional laparoscopic skills. Robotic surgery is safe in all types of gynaecological procedures and is a promising alternative for comprehensive gynaecologic surgical care.
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Objective

The aim of this research was to assess the role of robotics and its outcome in gynaecology both in benign and malignant cases in a single centre and provide a critical evaluation of possible advantages of robot assisted surgeries from surgeons’ point of view. Design A single centre, retrospective observational study. Population All women who underwent robotic gynaecological surgeries between 2015 and 2022.

Methods

The Da Vinci Si™ robotic system was used for these surgeries performed by all surgeons at our quaternary care centre, and data were acquired retrospectively through electronic medical records. Descriptive statistical analysis of data was done. Main outcome measures included operative time, estimated blood loss, hospital stay, complications and conversion rates in all cases. Age was analysed as a demographic data. Outcome A total of 211 robotic cases were performed including 172 hysterectomies, 20 myomectomies and 19 cases for other gynaecological indications. The mean operating time or hysterectomy and myomectomy was 113 and 129 min, respectively, and haemoglobin drop was 1.34 and 1.2 g/dl, respectively. No conversions to laparotomy were observed in either of the groups. The surgeries for 19 benign gynaecological conditions included ovarian cystectomy, cesarean scar repair and chronic cornual ectopic.

Conclusion

Robotic surgical system helps accomplish several procedures with exceptional laparoscopic skills. Robotic surgery is safe in all types of gynaecological procedures and is a promising alternative for comprehensive gynaecologic surgical care. Similar content being viewed by others

References

Lim PC, Crane JT, English EJ, et al. Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications. Int J Gynecol Obstet. 2016;133(3):359–64. Sinha R, Sanjay M, Rupa B, et al. Robotic surgery in gynecology. J Minimal Access Surg. 2015;11(1):50. Sundaram M, Basith A, Hemasree G. Robotics in gynecology. Operations Obstet Gynecol Text Atlas. 2020;27:474. Sinha R, Sundaram M, Raje S, et al. 3D laparoscopy: technique and initial experience in 451 cases. Gynecol Surg. 2013;10(2):123–8. Lawrie TA, Liu H, Lu D, et al. Robot-assisted surgery in gynaecology. Cochrane Database Syst Rev. 2019;4(4):CD011422. Payne TN, Dauterive FR. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol. 2008;15(3):286–91. Billfeldt NK, Borgfeldt C, Lindkvist H, et al. A Swedish population-based evaluation of benign hysterectomy, comparing minimally invasive and abdominal surgery. Eur J Obstet Gynecol Reprod Biol. 2018;1(222):113–8. Lee SR, Lee ES, Lee YJ, et al. Robot-assisted laparoscopic myomectomy versus abdominal myomectomy for large myomas sized over 10 cm or Weighing 250 g. Yonsei Med J. 2020;61(12):1054. Lee CY, Chen IH, Torng PL. Robotic myomectomy for large uterine myomas. Taiwan J Obstet Gynecol. 2018;57(6):796–800. Lonnerfors C. Robot-assisted myomectomy. Best Pract Res Clin Obstet Gynaecol. 2018;1(46):113–9. Munro MG, Gomel V. (2018). Reconstructive and reproductive surgery in gynecology: volume two: gynecological surgery. CRC press Nezhat C, Li A, Falik R, et al. Bowel endometriosis: diagnosis and management. Am J Obstet Gynecol. 2018;218(6):549–62. Maggiore UL, Ferrero S, Candiani M, et al. Bladder endometriosis: a systematic review of pathogenesis, diagnosis, treatment, impact on fertility, and risk of malignant transformation. Eur Urol. 2017;71(5):790–807. Soto E, Luu TH, Liu X, et al. Laparoscopy vs. robotic surgery for endometriosis (LAPROSE): a multicenter, randomized, controlled trial. Fertil Steril. 2017;107(4):996–1002. Acknowledgment Sherley Mathen, Zareena Khalid, Shamema A.S for their contribution to the case series Funding This study was not supported by any funding. Author information Authors and Affiliations Contributions BS and JS contributed to data collection and management, data analysis, writing and editing the article. KM contributed to conceptualisation, protocol development visualisation, supervision, writing—review and editing the article. Corresponding author Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Ethical Approval The study was performed following the principles of the Declaration of Helsinki and its modifications. Data were obtained from medical records and de-identifed, with no direct participation of patients. Informed Consent This was a retrospective observational study. The Institutional Research Ethics Committee has confirmed that no ethical approval is required and patient consent is waived. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. S. Mayadevi Kurup is a Senior Consultant; Suguna Bidarahalli is a Junior Consultant; Surya Jayaram is a Consultant. 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 Kurup, M., Bidarahalli, S. & Jayaram, S. Robotic Surgery in Gynaecology: A Retrospective Evaluation of an Experience at a Single Centre. J Obstet Gynecol India 74, 53–59 (2024). https://doi.org/10.1007/s13224-023-01852-x Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s13224-023-01852-x

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