title: Robot-assisted hysterectomy compared to open and laparoscopic approaches: systematic review and meta-analysis.
abstract: OBJECTIVE
  To review the safety and effectiveness of robot-assisted hysterectomy compared to traditional open and conventional laparoscopic surgery, differentiating radical, simple total with node staging, and simple total hysterectomy.
  
  
  METHODS
  Medline, Embase, the Cochrane library, and the Journal of Robotic Surgery were searched for controlled trials and observational studies with historic or concurrent controls. Data were pooled using random effects meta-analysis.
  
  
  RESULTS
  Compared to open surgery, robot-assisted radical hysterectomy is associated with reduced hospital stay and blood transfusions. For simple total hysterectomy with node staging, robot-assisted surgery is associated with reduced hospital stay, complications, and blood transfusions compared to open surgery. Compared to conventional laparoscopic surgery, robot-assisted simple total hysterectomy with node staging is associated with complications and conversions.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Health Technology Assessment, Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland. moneill@hiqa.ie
authors.forename: Michelle
authors.initials: M
authors.lastname: O'Neill
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Moran
authors.forename: Conor
authors.initials: C
authors.lastname: Teljeur
authors.forename: Orfhlaith E
authors.initials: OE
authors.lastname: O'Sullivan
authors.forename: Barry A
authors.initials: BA
authors.lastname: O'Reilly
authors.forename: Matt
authors.initials: M
authors.lastname: Hewitt
authors.forename: Martin
authors.initials: M
authors.lastname: Flattery
authors.forename: Máirín
authors.initials: M
authors.lastname: Ryan
mesh_terms: D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy; D007902:Length of Stay; D008198:Lymph Nodes / Q000473:pathology; D016239:MEDLINE; D011183:Postoperative Complications; D012371:Robotics; D016896:Treatment Outcome