Robot-assisted hysterectomy compared to open and laparoscopic approaches: systematic review and meta-analysis

Abstract

Compared to open surgery, robot-assisted hysterectomy offers benefits for reduced length of hospital stay and blood transfusions. The best evidence of improved outcomes is for simple total hysterectomy with node staging. Study quality was poor.

Robotic radical hysterectomy in early stage cervical cancer: A systematic review and meta-analysis

“…Furthermore, the robotic approach resulted in fewer complications for women who underwent simple total hysterectomy with nodal staging [52]. Another meta-analysis of 22 studies that evaluated surgical treatment in women with endometrial cancer concluded that robotic surgery, although more efficient, had higher surgical complication rates than laparoscopic surgery [51].…”

Tratamiento radical mínimamente invasivo en cáncer de cuello uterino invasor: experiencia de la Clínica Ginecotocológica A

“…Con respecto al sangrado severo y la necesidad de transfusiones está descrita una media de 0,8%-2,7%, en nuestra serie ninguna paciente requirió transfusión de glóbulos rojos (22,27) . No hubo complicaciones urinarias crónicas en nuestra serie.…”

Economic evaluation of robot‐assisted hysterectomy: a cost‐minimisation analysis

“…2 Furthermore, a high risk of bias was evident in these studies, with no randomisation for patient selection and only four of the studies reporting length of follow-up. We acknowledge that surgical practice varies between surgeons, hospitals and, indeed, country with regard to length of stay and transfusion rates.…”

“…2 The purpose of a systematic review is to gather all of the relevant available evidence. Given the practical difficulties of blinding a trial of robot-assisted surgery, by definition, none of the studies could be considered as high quality using the GRADE criteria.…”

“…For example, in abdominal wound repair, a meta-analysis of 23 trials involving 10 900 patients showed that interrupted suture led to a lower wound dehiscence risk (odds ratio 0.576). 2 In suturing for vascular reconstruction in the common carotid, hepatic, and coronary arteries, interrupted suture led to less stenosis of the vessel. 3,4 However, continuous suture is likely to lead to a faster completion of the procedure with a reduced cost.…”