Artikel

Laparoscopic versus robotic-assisted sacrocolpopexy for pelvic organ prolapse: a systematic review

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Abstract The use of robot-assisted surgery (RAS) has gained popularity in the field of gynaecology, including pelvic floor surgery. To assess the benefits of RAS, we conducted a sys-tematic review of randomized controlled trials comparing lap-aroscopic and robotic-assisted sacrocolpopexy. The Cochrane Library (1970–January 2015), MEDLINE (1966 to January 2015), and EMBASE (1974 to January 2015) were searched, as well as ClinicalTrials.gov and the International Clinical Trials Registry Platform. We identified two randomized trials (n=78) comparing laparoscopic with robotic sacrocolpopexy. The Paraiso 2011 study showed that laparoscopic was faster than robotic sacrocolpopexy (199±46 vs. 265±50 min; p< .001), yet in the ACCESS trial, no difference was present (225±62.3 vs. 246.5±51.3min;p= .110). Costs for using the robot were significantly higher in both studies, however, in the ACCESS trial, only when purchase and maintenance of the robot was included (LSC US$11,573 ± 3191 vs. RASC US$19,616±3135;p< .001). In the Paraiso study, RASC was more expensive even without considering those costs (LSC US$ 14,342 ± 2941 vs. RASC 16,278 ± 3326; p=0.008). Pain was reportedly higher after RASC, although at different time points after the operation. There were no differences in anatomical outcomes, pelvic floor function, and quality of life. The experience with RASC was tenfold lower than that with LSC in both studies. The heterogeneity between the two studies precluded a meta-analysis. Based on small randomized studies, with surgeons less experienced in RAS than in laparoscopic surgery, robotic surgery significant-ly increases the cost of a laparoscopic sacrocolpopexy. RASC would bemore sustainable if its costs would be lower. Though RASC may have other benefits, such as reduction of the learn-ing curve and increased ergonomics or dexterity, these remain to be demonstrated

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Informasi Detail

Judul Seri

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No. Panggil

Artikel

Penerbit

USA : Springer., 2016

Deskripsi Fisik

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Bahasa

English

ISBN/ISSN

DOI 10.1007/s10397-0

Klasifikasi

NONE

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

Gynecol Surg (2016) 13:115–123

Subjek

Medicine
laparoscopic
sacrocolpopexy
pelvic organ

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