Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework

Ong, HI; Shulman, N; Nugraha, P; Wrenn, S; Nally, D; Peirce, C; Mahmood, U; McCormick, J; Proud, D; Warrier, S; Fleming, C; Mohan, H

Author(s): Ong, HI; Shulman, N; Nugraha, P; Wrenn, S; Nally, D; Peirce, C; Mahmood, U; McCormick, J; Proud, D; Warrier, S; Fleming, C; Mohan, H;
Details: Publication Year 2024-06-26,Volume 39,Issue #1,Page 98
Journal Title: International Journal of Colorectal Disease
Publication Type: Review
Abstract: AIMS: This review aims to evaluate the feasibility of robot-assisted laparoscopic surgery (RALS) as an alternative to standard laparoscopic surgery (SLS) for the treatment of bowel deep-infiltrative endometriosis. Additionally, it aims to provide guidance for future study design, by gaining insight into the current state of research, in accordance with the IDEAL framework. METHOD: A systematic review was conducted to identify relevant studies on RALS for bowel deep infiltrating endometriosis in Medline, Embase, Cochrane Library and PubMed databases up to August 2023 and reported in keeping with PRISMA guidelines. The study was registered with PROSPERO Registration: CRD42022308611 RESULTS: Eleven primary studies were identified, encompassing 364 RALS patients and 83 SLS patients, from which surgical details, operative and postoperative outcomes were extracted. In the RALS group, mean operating time was longer (235 ± 112 min) than in the standard laparoscopy group (171 ± 76 min) (p < 0.01). Patients in the RALS group experienced a shorter hospital stay (5.3 ± 3.5 days vs. 7.3 ± 4.1 days) (p < 0.01), and appeared to have fewer postoperative complications compared to standard laparoscopy. Research evidence for RALS in bowel DE is at an IDEAL Stage 2B of development. CONCLUSION: RALS is a safe and feasible alternative to standard laparoscopy for bowel endometriosis treatment, with a shorter overall length of stay despite longer operating times. Further robust randomized trials recommended to delineate other potential advantages of RALS.
Publisher: Springer Nature
Keywords: Humans; *Endometriosis/surgery/pathology; Female; *Robotic Surgical Procedures/methods; *Laparoscopy; Postoperative Complications/etiology; Treatment Outcome; Length of Stay; Operative Time; Intestinal Diseases/surgery; Bowel surgery; Deep infiltrating endometriosis; Laparoscopy; Minimally invasive surgery; Robotic surgery; Surgical treatment
Department(s): Surgical Oncology
Publisher's Version: https://doi.org/10.1007/s00384-024-04669-w
Open Access at Publisher's Site: https://doi.org/10.1007/s00384-024-04669-w
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-08-27 04:40:31

Last Modified: 2024-08-27 04:48:12