Review ArticleSystematic Review of Robotic Surgery in Gynecology: Robotic Techniques Compared With Laparoscopy and Laparotomy
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Sources
Eleven members of the SGS SRG, which includes gynecologic surgeons and systematic review methodologists, performed a systematic search to identify studies of robotic-assisted laparoscopic gynecologic surgery. MEDLINE and the Cochrane Central Register of Controlled Trials were searched from inception to May 15, 2012, for English-language studies, using the search terms “Aesop,” “computer assisted,” “computer motion,” “da Vinci,” “gynecology,” “intuitive,” “robotics,” “surgery,” and “Zeus,” as
Study Selection
Abstracts were independently screened in duplicate using the computerized screening program abstrackr (Tufts Medical Center, Boston, MA) [2] with the following eligibility criteria: study participants were all women who had undergone robotic-assisted laparoscopic gynecologic surgery, and the studies evaluated robotic-assisted laparoscopic surgery. We included RCTs, prospective and retrospective comparative observational studies, and case-control studies of robotic-assisted vs nonrobotic
Results
The literature search yielded 1213 citations, of which 97 full-text articles were retrieved and rescreened. Of these, 30 comparative studies met eligibility criteria and were analyzed in the systematic review. Fourteen additional noncomparative articles were eligible for analysis of adverse events (Fig. 1).
Described are the clinical and associated outcomes from comparative studies, categorized according to the indications for surgery: surgical management of endometrial cancer (13 studies),
Discussion
The SGS SRG sought to summarize the available literature about robotics in gynecologic surgery and ultimately to develop a clinical practice guideline to help guide adoption of this new technology. However, the dearth of high-quality data precluded our group’s ability to develop meaningful recommendations. Although the available literature suggests that robotic and laparoscopic techniques seem to be no different for many outcomes, there is compelling evidence that robotics has advantages over
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The Society of Gynecologic Surgeons provided funding for assistance by methods experts in systematic review and logistic support.