Current status of robotically assisted laparoscopic surgery in reproductive medicine and gynaecology.
Laparoscopic techniques have revolutionized the concept of minimally invasive surgery. Robotically assisted surgery is one of the latest innovations in this field and many operative laparoscopic procedures have been performed in urology, cardiac and general surgery. More recently, the use of robotically assisted techniques have been introduced in gynaecology, and most available studies have shown it to be a safe and effective alternative to conventional laparoscopic surgery. However, whether or not to approach the management of certain gynaecological pathologies with a laparotomy or laparoscopy (conventional or with robotic aid) continues to be a point of debate. This article reviews recent developments in the endoscopic management of reproductive (tubal reanastomosis and myomectomies) and other gynaecological surgical conditions (hysterectomies, pelvic organ prolapse, repair of vesicovaginal fistulas and staging for gynaecological malignancies). Ongoing controversies associated with this technology, such as cost, learning curve, conversion rate to laparotomy, post-surgical fertility and complications, are briefly addressed. Long-term analysis of outcomes is ongoing.
Bocca
Silvina
S
The Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 601 Colley Avenue, Norfolk, VA 23507, USA. boccas@evms.edu
Stadtmauer
Laurel
L
Oehninger
Sergio
S
D005260:Female; D005298:Fertility; D005833:Genital Neoplasms, Female / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation; D010535:Laparoscopy / Q000009:adverse effects; D007889:Leiomyoma / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D018456:Reproductive Medicine / Q000295:instrumentation*; D012371:Robotics; D013243:Sterilization Reversal / Q000379:methods; D000267:Tissue Adhesions / Q000209:etiology; D014597:Uterine Rupture / Q000209:etiology; D014719:Vesicovaginal Fistula / Q000601:surgery