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

  • Michelle O’Neill
  • Patrick S. Moran
  • Conor Teljeur
  • Orfhlaith E. O’Sullivan
  • Barry A. O’Reilly
  • Matt Hewitt
  • Martin Flattery
  • Máirín Ryan
General Gynecology

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

Hysterectomy Meta-analysis Robot-assisted Systematic review 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Michelle O’Neill
    • 1
  • Patrick S. Moran
    • 1
  • Conor Teljeur
    • 1
  • Orfhlaith E. O’Sullivan
    • 2
  • Barry A. O’Reilly
    • 2
  • Matt Hewitt
    • 2
  • Martin Flattery
    • 3
  • Máirín Ryan
    • 1
  1. 1.Health Technology AssessmentHealth Information and Quality AuthorityDublin 7Ireland
  2. 2.Department of Obstetrics and GynecologyCork University Maternity HospitalCorkIreland
  3. 3.NHMRC Clinical Trials CentreUniversity of SydneySydneyAustralia

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