title: Robotic-assisted hysterectomy for the management of severe endometriosis: a retrospective review of short-term surgical outcomes.
abstract: OBJECTIVE
  The primary objective was to examine the safety and feasibility of robotic-assisted laparoscopy in a cohort of women treated surgically for stage III and IV endometriosis. The secondary objective was to explore whether the stage of endometriosis affected surgical outcome.
  
  
  METHODS
  In this cohort study, 43 women with severe endometriosis were treated with robot-assisted laparoscopic hysterectomy with unilateral or bilateral salpingooophorectomy for stage III (n = 19) or stage IV (n = 24) disease.
  
  
  RESULTS
  Histopathologic evaluation confirmed endometriosis in all patients, and fibroids were also shown in 12 patients. The median actual operative time was 145 min (range, 67-325 min), and the median blood loss was 100 mL (range, 20 - 400 mL). All but one of the procedures were completed successfully robotically. The length of hospital stay was 1 d for 95% of patients (41 of 43), and 2 patients had prolonged stays of 4 d and 5 d, respectively. One patient was readmitted for a vaginal cuff abscess; this represented the only complication identified in this series.
  
  
  CONCLUSIONS
  Robot-assisted laparoscopic surgery appears to be a reasonably safe and feasible method for the definitive surgical management of women with severe endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bedaiwy
authors.forename: Mohamed Y Abdel
authors.initials: MY
authors.lastname: Rahman
authors.forename: Mark
authors.initials: M
authors.lastname: Chapman
authors.forename: Heidi
authors.initials: H
authors.lastname: Frasure
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Mahajan
authors.forename: Vivian E
authors.initials: VE
authors.lastname: von Gruenigen
authors.forename: William
authors.initials: W
authors.lastname: Hurd
authors.forename: Kristine
authors.initials: K
authors.lastname: Zanotti
mesh_terms: D000328:Adult; D000368:Aged; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D010052:Ovariectomy; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome