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Robotic versus laparoscopic sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis

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International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Pelvic organ prolapse shows an increasing prevalence (3–50 %). The gold standard treatment for apical prolapse is sacrocolpopexy, which can be performed via minimal access (conventional laparoscopy or robotic surgery) or open sacrocolpopexy. The objective is to appraise the effectiveness and safety of robotic surgery compared with laparoscopic sacropexy in the treatment of apical prolapse.

Methods

Keywords were searched in: CINAHL, MEDLINE, CENTRAL, Cochrane MDSG Trials Register, Cochrane Library, Current Controlled Trials, ClinicalTrials.gov, WHO International Trials Registry Platform search portal, LILACS, and Google Scholar. A hand-search was also performed from IUJ and JMIG. Randomised and non-randomised controlled trials evaluating all women who underwent robotic sacropexy (RSC) or laparoscopic sacropexy (LSC) were included. A data extraction tool was used for data collection. RSC was compared with LSC. Narrative analysis and meta-analysis (RevMan) were conducted where appropriate.

Results

Nine papers compared RSC with LSC, involving 1,157 subjects. No significant difference was found between approaches for anatomical outcomes, mortality, hospital stay (MD: −0.72/95 % CI 1.72, 0.28], p = 0.16), and postoperative quality of life. However, robotic sacropexy had more postoperative pain and longer operating times, although fewer overall complications when performed concomitantly with hysterectomy (OR 0.35; 95 % CI 0.19–0.64).

Conclusions

Robotic sacropexy was related to more postoperative pain and longer operating times. However, no significant differences were found regarding anatomical outcomes, mortality, hospital stay or postoperative quality of life. Cautious interpretation of results is advised because of the risk of bias caused by the inclusion of non-randomised studies. More research comparing RSC with LSC is mandatory, particularly draw conclusions regarding estimated blood loss and complication rate.

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References

  1. Barber MD, Maher C (2013) Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J 24:1783–1790

    Article  PubMed  Google Scholar 

  2. Toozs-Hobson P, Kelvin B, Cardozo L (1998) Management of vaginal vault prolapse. Br J Obstet Gynaecol 105:13–17

    Article  CAS  PubMed  Google Scholar 

  3. Turner DA, Shaw C, McGrother CW, Dallosso HM, Cooper NJ (2004) The cost of clinically significant urinary storage symptoms for community dwelling adults in the UK. BJU Int 93(9):1246–1252

    Article  CAS  PubMed  Google Scholar 

  4. Subramanian D, Szwarcensztein K, Mauskopf JA, Slack MC (2009) Rate, type, and cost of pelvic organ prolapse surgery in Germany, France, and England. Eur J Obstet Gynecol Reprod Biol 144(2):177–181

    Article  PubMed  Google Scholar 

  5. Maher CF, Feiner B, Baessler K, Schmid C (2013) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 5:CD004014

    Google Scholar 

  6. Yohannes P, Rotariua P, Pintoa P, Smitha A, Leea B (2002) Comparison of robotic versus laparoscopic skills: is there a difference in the learning curve? Urology 60(1):39–45

    Article  PubMed  Google Scholar 

  7. Reza M, Maeso S, Blasco JA, Andradas E (2010) Meta-analysis of observational studies on the safety and effectiveness of robotic gynaecological surgery. Br J Surg 97(12):1772–1783

    Article  CAS  PubMed  Google Scholar 

  8. Liu H, Lu D, Wang L, Shi G, Song H, Clarke J (2012) Robotic surgery for benign gynaecological disease (review). Cochrane Database Syst Rev 2:CD00897

    Google Scholar 

  9. Higgins J, Green S (eds) (2008) Cochrane handbook for systematic reviews of interventions. Willey-Blackwell, Sussex

    Google Scholar 

  10. Serati M, Bogani G, Sorice P, Braga A, Torella M, Salvatore S, Uccella S, Cromi A, Ghezzi S (2014) Robot-assisted sacrocolpopexy for pelvic organ prolapse: a systematic review and meta-analysis of comparative studies. Eur Urol 66(2):303–318

    Article  PubMed  Google Scholar 

  11. Nosti PA, Umoh AU, Kane S, White DE, Harvie HS, Lowenstein L, Gutman RE (2014) Outcomes of abdominal and minimally invasive sacrocolpopexy: a retrospective cohort study. Female Pelvic Med Reconstr Surg 20(1):33–37

    Article  PubMed  Google Scholar 

  12. Pulliam SJ, Weinstein MM, Wakamatsu MM (2012) Minimally invasive apical sacropexy: a retrospective review of laparoscopic and robotic operating room experiences. Female Pelvic Med Reconstr Surg 18(2):122–126

    Article  PubMed  Google Scholar 

  13. De Gouveia De Sa M, Claydon LS, Whitlow B, Dolcet Artahona MA (2015) Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J. doi:10.1007/s00192-015-2765-y

  14. Weber AM, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski RR, Fischer J, Hull T, Nygaard I, Weidner AC (2001) The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J 12:178–186

  15. Antosh DD, Grotzke SA, McDonald MA, Shveiky D, Park AJ, Gutman RE, Sokol AI (2012) Short-term outcomes of robotic versus conventional laparoscopic sacral colpopexy. Female Pelvic Med Reconstr Surg 18(3):158–161

    Article  PubMed  Google Scholar 

  16. Anger JT, Geffen D, Mueller ER, Tarnay C, Smith B, Stroupe K, Rosenman A, Brubaker L, Bresee C, Kenton K (2014) Robotic compared with laparoscopic sacrocolpopexy: a randomized controlled trial. Obstet Gynecol 123(1):5–12

    Article  PubMed Central  PubMed  Google Scholar 

  17. Awad N, Mustafa S, Amit A, Deutsch M, Eldor-Itskovitz J, Lowenstein L (2013) Implementation of a new procedure: laparoscopic versus robotic sacrocolpopexy. Arch Gynecol Obstet 287(6):1181–1186

    Article  PubMed  Google Scholar 

  18. Paraiso MFR, Jelovsek JE, Frick A, Chen CCC, Barber MD (2011) Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse a randomized controlled trial. Obstet Gynecol 118(5):1005–1013

    Article  PubMed  Google Scholar 

  19. Chan SS, Pang SM, Cheung TH, Cheung RY, Chung TK (2011) Laparoscopic sacrocolpopexy for the treatment of vaginal vault prolapse: with or without robotic assistance. Hong Kong Med J 17(1):54–60

    CAS  PubMed  Google Scholar 

  20. Tan-Kim J, Menefee SA, Luber KM, Nager CW, Lukacz ES (2011) Robotic-assisted and laparoscopic sacrocolpopexy: comparing operative times, costs and outcomes. Female Pelvic Med Reconstr Surg 17(1):44–49

    Article  PubMed  Google Scholar 

  21. Seror J, Yates DR, Seringe E, Vaessen C, Bitker M, Chartier-Kastler E, Rouprêt M (2012) Prospective comparison of short-term functional outcomes obtained after pure laparoscopic and robot-assisted laparoscopic sacrocolpopexy. World J Urol 30(3):393–398

    Article  PubMed  Google Scholar 

  22. Danforth TL, Aron M, Ginsberg DA (2014) Robotic sacrocolpopexy. Indian J Urol 30(3):318–325

  23. Liu H, Lu D, Wang L, Shi G, Song H, Clarke J (2012) Robotic surgery for benign gynaecological disease (review). Cochrane Database Syst Rev 2:CD00897

    Google Scholar 

  24. Wright JD, Ananth CV, Lewin SN, Burke WM, Lu YS, Neugut AI, Herzog TJ, Hershman DL (2013) Robotically assisted vs laparoscopic hysterectomy among women with benign gynaecologic disease. J Am Med Assoc 309(7):689–698

    Article  CAS  Google Scholar 

  25. Rosero EB, Kho KA, Joshi G, Giesecke M, Schaffer JI (2013) Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease. Obstet Gynecol 122(4):778–786

    Article  PubMed Central  PubMed  Google Scholar 

  26. Paraiso MF, Ridgeway B, Park AJ, Jelovsek JE, Barber MD, Falcone T, Einarsson JI (2013) A randomized trial comparing conventional and robotically assisted total laparoscopic hysterectomy. Am J Obstet Gynecol 208(5):368.e1–368.e7

    Article  Google Scholar 

  27. Sarlos D, Kots L, Stevanovic N, von Felten S, Schär G (2012) Robotic compared with conventional laparoscopic hysterectomy: a randomized controlled trial. Obstet Gynecol 120(3):604–611

    Article  PubMed  Google Scholar 

  28. Marshall DA, George SA, McDonald MA, Shveiky D, Park AJ, Gutman RG, Sokol AI (2010) Short-term outcomes of robotic vs. conventional laparoscopic sacrocolpopexy. J Minim Invasive Gynecol 17(6):S89, abstract only

    Article  Google Scholar 

  29. Unger CA, Paraiso MR, Jelovsek J, Barber MD, Ridgeway B (2014) Peri- and postoperative outcomes after robotic-assisted and conventional laparoscopic sacrocolpopexy. J Minim Invasive Gynecol 21(2):S12–S13, abstract only

    Article  Google Scholar 

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Acknowledgements

We would like to acknowledge the valuable guidance of Andrea De Gouveia De Sa as a research assistant in the development of this paper and the Team from Anglia Ruskin University library for their support in the database search and acquisition of the majority of the papers included.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Faculty of Medical Science, Anglia Ruskin University, Chelmsford, United Kingdom

    Maribel De Gouveia De Sa, Leica Sarah Claydon & Barry Whitlow

  2. Pelvic Reconstructive Surgeon, Hospital Carlos J. Bello, Caracas, Venezuela

    Maria Angelica Dolcet Artahona

Authors
  1. Maribel De Gouveia De Sa
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  2. Leica Sarah Claydon
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  3. Barry Whitlow
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  4. Maria Angelica Dolcet Artahona
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Corresponding author

Correspondence to Maribel De Gouveia De Sa.

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De Gouveia De Sa, M., Claydon, L.S., Whitlow, B. et al. Robotic versus laparoscopic sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J 27, 355–366 (2016). https://doi.org/10.1007/s00192-015-2763-0

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  • DOI: https://doi.org/10.1007/s00192-015-2763-0

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