Meta-analysis of observational studies on the safety and effectiveness of robotic gynaecological surgery

Author:

Reza M1,Maeso S1,Blasco J A1,Andradas E1

Affiliation:

1. Health Technology Assessment Unit, Laín Entralgo Agency, C/Gran Vía 27, 7°, Madrid 28013, Spain

Abstract

Abstract Background The safety and effectiveness of robotic, open and conventional laparoscopic surgery in gynaecological surgery was assessed in a systematic review of the literature. This will enable the general surgical community to understand where robotic surgery stands in gynaecology. Methods A search was made for previous systematic reviews in the Abstracts of Reviews of Effects, Health Technology Assessment, Cochrane Collaboration and Hayes Inc. databases. In addition, the MEDLINE, Embase and CINAHL databases were searched for primary studies. The quality of studies was assessed and meta-analyses were performed. Results Twenty-two studies were included in the review. All were controlled but none was randomized. The majority were retrospective with historical controls. The settings in which robotic surgery was used included hysterectomy for malignant and benign disease, myomectomy, sacrocolpopexy, fallopian tube reanastomosis and adnexectomy. Robotic surgery achieved a shorter hospital stay and less blood loss than open surgery. Compared with conventional laparoscopic surgery, robotic surgery achieved reduced blood loss and fewer conversions during the staging of endometrial cancer. No clinically significant differences were recorded for the other indications tested. Conclusion The available evidence shows that robotic surgery offers limited advantages with respect to short-term outcomes. However, the clinical outcomes should be interpreted with caution owing to the methodological quality of the studies.

Funder

Spanish Ministry of Health

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference31 articles.

1. Emergence of robotic assisted surgery in gynecologic oncology: American perspective;Mendivil;Gynecol Oncol,2009

2. The use of robot-assisted laparoscopic hysterectomy in the patient with a scarred or obliterated anterior cul-de-sac;Advincula;JSLS,2005

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