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

  • General Gynecology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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Conflict of interest

MON, PSM, CT, OEOS, MF, and MR have no conflicts of interest to declare. BAOR and MH are proctors for Intuitive Surgical, with all financial reimbursements from the company placed in the Department of Obstetrics and Gynecology research fund.

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Authors and Affiliations

  1. Health Technology Assessment, Health Information and Quality Authority, George’s Court, George’s Lane, Dublin 7, Ireland

    Michelle O’Neill, Patrick S. Moran, Conor Teljeur & Máirín Ryan

  2. Department of Obstetrics and Gynecology, Cork University Maternity Hospital, Cork, Ireland

    Orfhlaith E. O’Sullivan, Barry A. O’Reilly & Matt Hewitt

  3. NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia

    Martin Flattery

Authors
  1. Michelle O’Neill
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  2. Patrick S. Moran
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  4. Orfhlaith E. O’Sullivan
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Correspondence to Michelle O’Neill.

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O’Neill, M., Moran, P.S., Teljeur, C. et al. Robot-assisted hysterectomy compared to open and laparoscopic approaches: systematic review and meta-analysis. Arch Gynecol Obstet 287, 907–918 (2013). https://doi.org/10.1007/s00404-012-2681-z

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  • DOI: https://doi.org/10.1007/s00404-012-2681-z

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