J Korean Med Assoc.  2019 Apr;62(4):209-215. 10.5124/jkma.2019.62.4.209.

Robot-assisted surgery in gynecology

• Chung YJ
• Kim MR

• KMID: 2442737
• DOI: http://doi.org/10.5124/jkma.2019.62.4.209

Abstract

The development of robotic technology has facilitated the application of minimally invasive techniques for complex gynecologic surgery. Robot-assisted gynecologic surgery has grown exponentially since receiving Food and Drug Administration approval for use in gynecologic surgery in 2005. Robotic surgery has several major advantages, including three-dimensional visual magnification, articulation beyond normal manipulation, and the filtering of the operator's hand tremors. Therefore, robotic surgery is suitable for microsurgery, and it could be an alternative option for laparotomy. Robotic surgery has advantages, especially for suture-intensive operations such as myomectomy. Patients who underwent robot-assisted laparoscopic myomectomy had significantly decreased estimated blood loss, complication rates, and length of hospital stay. The advantages of robotic surgery help to overcome the limitations of laparoscopy, especially for complicated procedures in deep infiltrating endometriosis. Although extensive radical operations for deep infiltrating endometriosis of the bowel and urinary tract, such as segmental resections of the bladder, ureters, and bowel, were performed by laparotomy in the past, they are now performed more easily and more effectively using robotic techniques. In a recent systematic review and meta-analysis, robotic and laparoscopic sacrocolpopexy resulted in similar clinical outcomes, but robotic surgery was associated with a longer operation time and higher costs. Robotic and conventional laparoscopic hysterectomy show equivalent surgical and clinical outcomes. Compared to laparotomy, robotic gynecologic cancer surgery results in improved clinical outcomes and comparable oncologic outcomes. If robotic surgery is tailored in terms of patient selection, surgeon ability, and equipment availability, it could be a feasible option for highly advanced minimally invasive surgery.

Keyword

Robotic surgical procedures; Minimally invasive surgical procedures; Uterine myomectomy; Hysterectomy; Trachelectomy

MeSH Terms

Endometriosis
Female
Gynecologic Surgical Procedures
Gynecology*
Hand
Humans
Hysterectomy
Laparoscopy
Laparotomy
Length of Stay
Microsurgery
Minimally Invasive Surgical Procedures
Patient Selection
Robotic Surgical Procedures
Trachelectomy
Tremor
United States Food and Drug Administration
Ureter
Urinary Bladder
Urinary Tract
Uterine Myomectomy

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