title: Robotic-assisted laparoscopy in reproductive surgery: a contemporary review.
abstract: Robotic surgery is a conceptual fusion of the conventional open surgery and the minimally invasive laparoscopic surgery. We reviewed the current role of robotic-assisted laparoscopy in the field of reproductive surgery by a literature search in PubMed database. We analyzed the reported advantages and limitations of the use of robotics in reproductive surgeries like myomectomy, tubal reanastomosis, endometriosis, ovarian tissue cryopreservation, and ovarian transposition. Overall, robotic assistance in reproductive surgery resulted in decreased blood loss, less post-operative pain, shorter hospital stay, and faster convalescence, whereas reproductive outcomes were similar to open/laparoscopic approaches. The main drawbacks of robotic surgery were higher cost and longer operating times. It is as safe and effective as the conventional laparoscopy and represents a reasonable alternate to abdominal approach. Procedures that are technically challenging with the conventional laparoscopy can be performed with robotic assistance. It has advantages of improved visualization and Endowrist™ movements allowing precise suturing. This helps to overcome the limitations of laparoscopy, especially in complicated procedures, and may shorten the steep learning curve in minimal invasive surgery. Randomized controlled trials looking at both short- and long-term outcomes are warranted to strengthen the role of robotic surgery in the field of reproductive surgery.
authors.affiliation: Center for Reproductive Medicine, Orlando, FL, USA. drjphari@gmail.com.
authors.forename: Jayapriya
authors.identifier: http://orcid.org/0000-0001-8749-1882
authors.initials: J
authors.lastname: Jayakumaran
authors.affiliation: Center for Reproductive Medicine, Orlando, FL, USA.
authors.forename: Sejal D
authors.initials: SD
authors.lastname: Patel
authors.affiliation: Center for Reproductive Medicine, Orlando, FL, USA.
authors.forename: Bhushan K
authors.initials: BK
authors.lastname: Gangrade
authors.affiliation: Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Deepa Maheswari
authors.initials: DM
authors.lastname: Narasimhulu
authors.affiliation: Lifeline Superspeciality Hospital, Adoor, Kerala, India.
authors.forename: Soundarya Ramanatha
authors.initials: SR
authors.lastname: Pandian
authors.affiliation: Center for Reproductive Medicine, Orlando, FL, USA.
authors.forename: Celso
authors.initials: C
authors.lastname: Silva
mesh_terms: D015925:Cryopreservation / Q000379:methods; D004715:Endometriosis / Q000601:surgery; D005260:Female; D005836:Genitalia, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures; D010053:Ovary / Q000601:surgery; D065287:Robotic Surgical Procedures; D013243:Sterilization Reversal / Q000379:methods; D063186:Uterine Myomectomy / Q000379:methods
keywords: Endometriosis; Myomectomy; Reproductive surgery; Robotic-assisted laparoscopy; Tubal reanastomosis