Archives of Gynecology and Obstetrics

, Volume 287, Issue 5, pp 907–918

Robot-assisted hysterectomy compared to open and laparoscopic approaches: systematic review and meta-analysis

Authors

    • Health Technology AssessmentHealth Information and Quality Authority
  • Patrick S. Moran
    • Health Technology AssessmentHealth Information and Quality Authority
  • Conor Teljeur
    • Health Technology AssessmentHealth Information and Quality Authority
  • Orfhlaith E. O’Sullivan
    • Department of Obstetrics and GynecologyCork University Maternity Hospital
  • Barry A. O’Reilly
    • Department of Obstetrics and GynecologyCork University Maternity Hospital
  • Matt Hewitt
    • Department of Obstetrics and GynecologyCork University Maternity Hospital
  • Martin Flattery
    • NHMRC Clinical Trials CentreUniversity of Sydney
  • Máirín Ryan
    • Health Technology AssessmentHealth Information and Quality Authority
General Gynecology

DOI: 10.1007/s00404-012-2681-z

Cite this article as:
O’Neill, M., Moran, P.S., Teljeur, C. et al. Arch Gynecol Obstet (2013) 287: 907. doi:10.1007/s00404-012-2681-z

Abstract

Purpose

To review the safety and effectiveness of robot-assisted hysterectomy compared to traditional open and conventional laparoscopic surgery, differentiating radical, simple total with node staging, and simple total hysterectomy.

Methods

Medline, Embase, the Cochrane library, and the Journal of Robotic Surgery were searched for controlled trials and observational studies with historic or concurrent controls. Data were pooled using random effects meta-analysis.

Results

Compared to open surgery, robot-assisted radical hysterectomy is associated with reduced hospital stay and blood transfusions. For simple total hysterectomy with node staging, robot-assisted surgery is associated with reduced hospital stay, complications, and blood transfusions compared to open surgery. Compared to conventional laparoscopic surgery, robot-assisted simple total hysterectomy with node staging is associated with complications and conversions.

Conclusions

Compared to open surgery, robot-assisted hysterectomy offers benefits for reduced length of hospital stay and blood transfusions. The best evidence of improved outcomes is for simple total hysterectomy with node staging. Study quality was poor.

Keywords

HysterectomyMeta-analysisRobot-assistedSystematic review

Copyright information

© Springer-Verlag Berlin Heidelberg 2013