Laparoscopic vs. Robotic Surgery for Endometriosis

Laparoscopic vs. Robotic Surgery for Endometriosis

Outcomes can be equally good with either procedure

Contrary to the common expectation that robotic assistance can improve the outcomes of endometriosis surgery, a study found no evidence it is either superior or inferior to traditional laparoscopic technique.

“Both robotic and laparoscopic surgery improve quality of life and relieve pain when the procedures are done by experts in endometriosis,” says Tommaso Falcone, MD, Chairman, Ob/Gyn & Women’s Health Institute at Cleveland Clinic.

This conclusion is the result of a multicenter, randomized clinical trial comparing the use of traditional laparoscopic surgery with robot assisted surgery in women with endometriosis. The primary outcome was operative time. Secondary outcomes included perioperative complications and quality of life.

No difference in operative time was seen between the two groups. Nor were there differences in blood loss, intraoperative complications, postoperative complications, rates of conversion to laparotomy or quality of life improvement.

Laparoscopic vs. Robotic Surgery for Endometriosis

Cleveland Clinic
One of the world’s first and largest group practices, Cleveland Clinic was founded in 1921 by four physicians who believed that patients would receive the best possible care when clinical medicine was integrated with research and education. Since then, millions of patients from every state and 100 countries have received care at Cleveland Clinic.

Cleveland Clinic consistently has been recognized as one of the nation’s best hospitals and the Ob/Gyn & Women’s Health Institute is ranked among the top departments in the country.

Abstract

Objective: To determine whether the use of the robot for surgical treatment of endometriosis is better than traditional laparoscopy in terms of operative length, perioperative parameters, and quality of life outcomes.

Design: Multicenterrandomized clinical trial.

Setting: University teaching hospitals.

Patient(s): Women aged >18 years with suspected endometriosis who elected to undergo surgical management.

Intervention(s): Randomization to conventional or robot-assisted laparoscopic removal of endometriosis.

Main Outcome Measure(s): The primary outcome measured was operative time. Secondary outcomes were perioperative complications and quality of life.

Result(s): The mean operative time for robotic vs. laparoscopic surgery for endometriosis was 106.6 ± 48.4 minutes vs. 101.6 ± 63.2 minutes. There were no differences in blood loss, intraoperative or postoperative complications, or rates of conversion to laparotomy in the two arms. Both groups reported significant improvement on condition-specific quality of life outcomes at 6 weeks and 6 months.

Conclusion(s): There were no differences in perioperative outcomes between robotic and conventional laparoscopy.

sources:

ncbi.nlm.nih.gov

consulted.clevelandclinic.org

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