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Meta-Analysis
. 2024 Feb;38(2):529-539.
doi: 10.1007/s00464-023-10587-9. Epub 2023 Dec 7.

Robot-assisted laparoscopy does not have demonstrable advantages over conventional laparoscopy in endometriosis surgery: a systematic review and meta-analysis

Ádám Csirzó  1   2 , Dénes Péter Kovács  1   2 , Anett Szabó  1   3 , Péter Fehérvári  1   4 , Árpád Jankó  1 , Péter Hegyi  1   5 , Péter Nyirády  1   3 , Zoltán Sipos  6   7 , Levente Sára  1   2 , Nándor Ács  1   2 , István Szabó  2 , Sándor Valent  8   9
Affiliations
Meta-Analysis

Robot-assisted laparoscopy does not have demonstrable advantages over conventional laparoscopy in endometriosis surgery: a systematic review and meta-analysis

Ádám Csirzó et al. Surg Endosc. 2024 Feb.

Abstract

Background: Endometriosis is a chronic condition affecting 6-10% of women of reproductive age, with endometriosis-related pain and infertility being the leading symptoms. Currently, the gold standard treatment approach to surgery is conventional laparoscopy (CL); however, the increasing availability of robot-assisted surgery is projected as a competitor of CL. This study aimed to compare the perioperative outcomes of robot-assisted laparoscopy (RAL) and CL in endometriosis surgery.

Objectives: We aimed to compare the effectiveness and safety of these two procedures.

Methods: A systematic search was conducted in three medical databases. Studies investigating different perioperative outcomes of endometriosis-related surgeries were included. Results are presented as odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI).

Results: Our search yielded 2,014 records, of which 13 were eligible for data extraction. No significant differences were detected between the CL and RAL groups in terms of intraoperative complications (OR = 1.07, CI 0.43-2.63), postoperative complications (OR = 1.3, CI 0.73-2.32), number of conversions to open surgery (OR = 1.34, CI 0.76-2.37), length of hospital stays (MD = 0.12, CI 0.33-0.57), blood loss (MD = 16.73, CI 4.18-37.63) or number of rehospitalizations (OR = 0.95, CI 0.13-6.75). In terms of operative times (MD = 28.09 min, CI 11.59-44.59) and operating room times (MD = 51.39 min, CI 15.07-87.72;), the RAL technique remained inferior.

Conclusion: RAL does not have statistically demonstrable advantages over CL in terms of perioperative outcomes for endometriosis-related surgery.

Keywords: DIE; Da Vinci Surgical System; Deep infiltrating endometriosis; Multiport; Single-port; rASRM.

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Conflict of interest statement

Drs. Ádám Csirzó, Dénes Péter Kovács, Anett Szabó, Péter Hegyi, Péter Nyirády, Levente Sára, Nándor Ács, István Szabó, Sándor Valent and Mr. Péter Fehérvári, Árpád Jankó, Zoltán Sipos have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of the selection process
Fig. 2
Fig. 2
The comparison of RAL and CL in terms of odds ratio of intraoperative complications (event numbers)
Fig. 3
Fig. 3
The comparison of RAL and CL in terms of odds ratio of postoperative complications (event numbers)
Fig. 4
Fig. 4
The comparison of RAL and CL in terms of mean difference of operating times (minutes)
Fig. 5
Fig. 5
The comparison of RAL and CL in terms of mean difference of operating room times (minutes)
See this image and copyright information in PMC

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