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Systematic review of robotic surgery in gynecology: robotic techniques compared with laparoscopy and laparotomy
- Source :
- Journal of minimally invasive gynecology. 21(3)
- Publication Year :
- 2013
-
Abstract
- The Society of Gynecologic Surgeons Systematic Review Group performed a systematic review of both randomized and observational studies to compare robotic vs nonrobotic surgical approaches (laparoscopic, abdominal, and vaginal) for treatment of both benign and malignant gynecologic indications to compare surgical and patient-centered outcomes, costs, and adverse events associated with the various surgical approaches. MEDLINE and the Cochrane Central Register of Controlled Trials were searched from inception to May 15, 2012, for English-language studies with terms related to robotic surgery and gynecology. Studies of any design that included at least 30 women who had undergone robotic-assisted laparoscopic gynecologic surgery were included for review. The literature yielded 1213 citations, of which 97 full-text articles were reviewed. Forty-four studies (30 comparative and 14 noncomparative) met eligibility criteria. Study data were extracted into structured electronic forms and reconciled by a second, independent reviewer. Our analysis revealed that, compared with open surgery, robotic surgery consistently confers shorter hospital stay. The proficiency plateau seems to be lower for robotic surgery than for conventional laparoscopy. Of the various gynecologic applications, there seems to be evidence that renders robotic techniques advantageous over traditional open surgery for management of endometrial cancer. However, insofar as superiority, conflicting data are obtained when comparing robotics vs laparoscopic techniques. Therefore, the specific method of minimally invasive surgery, whether conventional laparoscopy or robotic surgery, should be tailored to patient selection, surgeon ability, and equipment availability.
- Subjects :
- Adult
medicine.medical_specialty
medicine.medical_treatment
MEDLINE
Gynecologic Surgical Procedures
Laparotomy
medicine
Humans
Minimally Invasive Surgical Procedures
Robotic surgery
Laparoscopy
Adverse effect
Randomized Controlled Trials as Topic
Gynecology
Surgical approach
medicine.diagnostic_test
business.industry
General surgery
Endometrial cancer
Obstetrics and Gynecology
Robotics
Length of Stay
medicine.disease
Surgery
Endometrial Neoplasms
Observational Studies as Topic
Uterine Neoplasms
Observational study
Female
business
Learning Curve
Subjects
Details
- ISSN :
- 15534669
- Volume :
- 21
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of minimally invasive gynecology
- Accession number :
- edsair.doi.dedup.....57752f1eda4320824d4379ad2900e785