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Capozzi, V.A.; Scarpelli, E.; , .; Celardo, A.; Torella, M.; Cianci, S. Robotic Surgery in Benign Gynecological Pathology. Encyclopedia. Available online: https://encyclopedia.pub/entry/22096 (accessed on 05 December 2025).
Capozzi VA, Scarpelli E,  , Celardo A, Torella M, Cianci S. Robotic Surgery in Benign Gynecological Pathology. Encyclopedia. Available at: https://encyclopedia.pub/entry/22096. Accessed December 05, 2025.
Capozzi, Vito Andrea, Elisa Scarpelli,  , Angela Celardo, Marco Torella, Stefano Cianci. "Robotic Surgery in Benign Gynecological Pathology" Encyclopedia, https://encyclopedia.pub/entry/22096 (accessed December 05, 2025).
Capozzi, V.A., Scarpelli, E., , ., Celardo, A., Torella, M., & Cianci, S. (2022, April 21). Robotic Surgery in Benign Gynecological Pathology. In Encyclopedia. https://encyclopedia.pub/entry/22096
Capozzi, Vito Andrea, et al. "Robotic Surgery in Benign Gynecological Pathology." Encyclopedia. Web. 21 April, 2022.
Robotic Surgery in Benign Gynecological Pathology
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This entry is adapted from the peer-reviewed paper 10.3390/medicina58040552

Since the Food and Drug Administration’s (FDA) approval in 2005, the application of robotic surgery (RS) in gynecology has been adopted all over the world. Currently, a minimally invasive approach is suggested in benign gynecological pathologies. RS has comparable clinical outcomes compared to laparoscopy (LPS). RS allowed a growing number of patients to gain access to minimally invasive surgery (MIS) and benefit from a minimally invasive treatment, due to a flattened learning curve and enhanced dexterity and visualization.

robotic surgery gynecology myomectomy

1. Introduction

In the last decades, minimally invasive surgery (MIS) was widespread both in benign and malignant pathologies [1][2]. Furthermore, since the Food and Drug Administration (FDA) approval in 2005, the application of robotic surgery (RS) in gynecology was adopted all over the world [3]. MIS is associated with a minor length of hospital stay, less blood loss, a reduction in postoperative pain, and superior long-term quality of life compared to the open approach [4]. Furthermore, the MIS approach is also encouraged by Enhanced Recovery After Surgery (ERAS) recommendations as a tool to improve fast recovery after surgery [5]. However, laparoscopy (LPS) and RS require a fair number of procedures for one to become confident with the surgical gestures, with a slow learning curve. LPS is characterized by two-dimensional visualization, a limited range of motions, difficulty with hand-eye coordination, and enhanced physiologic tremors [6]. Therefore, the introduction of RS provided the same LPS advantages with additional improvements. Moreover, RS with the 3D visualization, wristed instrumentation, and improved ergonomics can facilitate the surgical gestures of inexperienced surgeons [7]. However, due to the emerging technology and specific equipment, RS has higher costs and longer operative times compared to open and LPS approaches. In light of these data, the RS application presents known advantages for patients and surgeons but not always strong scientific evidence to support its use in clinical practice.

2. Robotic Myomectomy

Leiomyoma is the most common benign gynecologic tumor diagnosed in women during reproductive age. The true incidence in the general population is unknown because fibromas are often asymptomatic. However, almost 60% of women in reproductive age have fibroids [8]. The most common clinical presentation is abnormal uterine bleeding, bulk symptoms, and infertility. Fibroids can be classified depending on their uterine localizations according to the International Federation of Gynecology and Obstetrics (FIGO) [9]. Myomectomy is a safe treatment in symptomatic patients who desire to preserve their fertility. The fertility preserving surgical approach includes abdominal myomectomy (AM), laparoscopic myomectomy (LM), and robotic-assisted myomectomy (RAM). The appropriate surgical treatment should be individualized depending on myoma dimensions, number, localization, and surgeon skills.
In a large prospective randomized trial published in 2000 comparing LM and AM, LPS was associated with a minor length of hospital stay, less blood loss, smaller scars, faster recovery, and a non-inferiority pregnancy rate [10]. However, LPS is also characterized by some limitations. In the absence of a wide range of motion and limited visualization as in the case of a large uterus, laparoscopic dissection may be challenging. Besides, experts’ opinions suggest that LPS is contraindicated for fibroids greater than 10–12 cm and in the presence of more than three lesions requiring multiple uterine incisions.
RM has gained wide acceptance because robotic endowrist instruments offer better maneuverability and facilitated sutures. Moreover, RS is comparable to LPS in terms of enhanced recovery, perioperative outcomes, and cosmetic results. Limitations may derive from the lack of haptic feedback, in particular in controlling strength in suturing, in case of need for closure of cavity defect after myomectomy, and the individuation and location of small myomas. Furthermore, the removal of large myomas could be laborious due to the reduction of the surgical field visibility. To date, no randomized clinical trials comparing RM to open or laparoscopic approaches are available in the literature. However, retrospective non-inferiority trials support RM feasibility. In 2007, Advincula et al. published a retrospective case-matched study including 58 patients with symptomatic leiomyomas undergoing AM or RAM. The results showed higher postoperative complications, greater blood loss, and longer hospital stays in the AM group. Nevertheless, higher costs and longer operative times were reported in the RAM group [11]. In a retrospective analysis of 81 LM and RAM cases, Bedient et al. reported comparable short-term outcomes for both approaches, while long-term outcomes were not assessed [12].
Along with these results, Nezhat et al., in a retrospective case-matched study of 50 patients (35 LM and 15 RAM), reported longer operative times in the RS group and comparable post-operative short-term outcomes when compared to LM. Furthermore, the same researchers reported that the main RAM advantage was the flattened learning curve that could allow less experienced endoscopic surgeons to perform MIS [13].
In 2012, with a large retrospective trial (115 LMs and 174 RAMs), Gargiulo et al. reported that LM and RAM have comparable short-term surgical outcomes [14]. RAM had longer operative times and larger estimated blood loss; however, during LM, a higher rate of the barbed suture were performed (67.9% vs. 5%), with significant impact on suturing time and blood loss. Subsequently, Barakat et al. published a large retrospective study on 575 myomectomies, comparing AM, LA, and RAM. Researchers found that RAM was associated with decreased blood loss and less length of hospital stay compared with traditional LPS and AM. Furthermore, RM and LM shared comparable advantages compared to open surgery in terms of perioperative outcomes. However, myoma diameters were significantly higher in the robotic and open surgery arms compared to the laparoscopic group [15]. In line with these researchers , Gobern et al. reported shorter hospital stays and decreased blood loss in the MIS group in a retrospective analysis of 308 procedures (169 AM, 73 LM, and 66 RAM) [16].
In a recent large retrospective trial conducted by Özbaşlı et al., researchers reported the safety and feasibility of a robotic-assisted approach in patients with large uterine size and myomas. Moreover, RAM patients experienced significantly reduced post-operative pain compared to AM and LM patients [17].
Long-term surgical outcomes were investigated in a retrospective study conducted by Flyckt et al. analyzing 133 myomectomies (80 AMs, 28 LM, and 25 RAM). After a median follow-up of eight years, women wishing for pregnancy showed a 55% pregnancy rate without a statistically significant difference in the three groups. Moreover, the bleeding symptom control was similar regardless of the surgical approach used [18]. Furthermore, no cases of uterine rupture were reported in the MIS groups [19]. In line with these researchers, in a recent retrospective case series, Goldberg et al. reported a 70% pregnancy rate in 123 patients undergoing RAM [20].

3. Robotic Hysterectomy

Hysterectomy is one of the most performed surgical procedures worldwide. In 90% of cases, benign pathologies are the main indication for the surgical procedure [21]. Surgical approaches to benign hysterectomy include laparotomy, LPS, vaginal and robotic techniques [22].
Over time, both open and vaginal approaches are decreasing in popularity, while the widespread adoption of robotic-assisted hysterectomy gave access to a larger number of patients to minimally invasive techniques, even in cases of severe obesity [23].
First, in 2009 and subsequently in 2021, the American College of Obstetricians and Gynecologists (ACOG) recommended the MIS approach as the gold standard for hysterectomy. Furthermore, among minimally invasive techniques, the vaginal route should be the primary choice whenever feasible [24].
Nevertheless, concern for malignancy, large uterine size, a fixed uterus, or the lack of confidence of the surgeon may preclude the vaginal approach. When the vaginal route is not indicated or feasible, LPS is mentioned as the preferred alternative to open surgery [25]. Advantages of laparoscopic hysterectomy (LH) over open abdominal hysterectomy (AH) include decreased postoperative pain, shorter hospital stay, and quicker return to daily activities [26]. However, the steep learning curve, counter-intuitive hand movement, as well as limited instruments movement and two-dimensional visualization are limitations of the technique [27].
On the other hand, robotic hysterectomy (RH) requires a lower level of technical skill with more intuitive surgical gestures compared to LH [28]. As a consequence, RH gained great popularity thanks to the easy adoption of the technique, even in the absence of strong evidence supporting RH over LH [29][30]. Despite lacking a strict indication for use of robotic-assisted hysterectomy, the RH may represent a suitable minimally invasive option in less optimal candidates for LPS. In particular, RS may offer a favorable alternative in severely obese patients [31].
In a population-based retrospective study conducted by Wright et al. on 264,758 women undergoing hysterectomy for benign disease, researchers found that LH and RH share comparable postoperative outcomes, although RS was associated with higher costs [32]. RH advantages and disadvantages were also assessed in randomized clinical trials. In a blinded, prospective randomized controlled trial conducted by Paraiso et al., 53 patients were randomized to LH (n = 27) and RH (n = 26). Researchers reported a low complication rate for both approaches without statistically significant differences between the two groups. No intraoperative lesions or need for transfusions was registered. Furthermore, RH was associated with longer operative time, good postoperative pain control, and a fast return to daily activities [33]. In line with these results, Sarlos et al., in an RCT enrolling 95 patients who underwent LH or RH reported higher operating times in the robotic group and similar surgical and postoperative outcomes. Furthermore, patients enrolled in the RH arm reported a higher level of short term postoperative quality of life [34]. Lonnerfors et al. in an RCT with 122 patients (61 LH vs. 61 RH), also reported better short-term outcomes and a lower rate of postoperative complications in RH compared to the LH group. Concerning operative times, there were no differences between LH and RH. This may suggest that, where RS is well implemented, operating room time is not affected [35]. In agreement with this observation, Deimling et al. found no significant difference in operating time between LH and RH within the 144 cases analyzed. The mean operative time in the RH group was 73.9 min and 74.9 min in the LH group. Researchers concluded that RS when performed by experienced surgeons is not inferior to LPS in terms of operative time [36].

4. Robotic Endometriosis Treatment

Endometriosis is a chronic inflammatory condition that affects women during reproductive age. Endometriosis is associated with pelvic pain and infertility, but the severity of symptoms is not predictive of the stage of the disease. Endometriosis eradication is one of the most complex laparoscopic surgeries due to the distortion of the normal anatomy, adhesions, and hypomobility of the pelvic organs [37].
Surgical treatment depends on symptoms, response to medications, and women’s fertility status. Currently, although MIS is the approach of choice, no indication as to which MIS approach to prefer is present in the literature [38]. LPS is accepted as the preferred technique because of comparable outcomes to open surgery with the known advantages of MIS [39]. To date, scientific evidence about RS in endometriosis cases is limited. Many studies report that RS in endometriosis is a feasible and safe option [40][41][42]. However, most of these studies are retrospective in nature or with a limited number of cases reported. On the other hand, RS uses are reported in complex cases of deep infiltrating endometriosis with urinary and bowel involvement.
The LAROSE trial [43] is a prospective randomized clinical trial comparing LPS to RS in terms of operative times and perioperative outcomes in endometriotic disease. In the 53 patients enrolled (38 LPS vs. 35 RS), RS was shown to be non-inferior to LPS for both aspects. Even after adjustment for the stage of disease, operative times and quality of life after a six-month follow-up were similar. Further evidence comes from retrospective clinical trials [40][41][42][44] comparing robotic and laparoscopic approaches.
These retrospective studies showed minor operative times for LPS and superimposable complication rates compared to RS. However, due to their retrospective nature, comparison between LPS and RS is limited by the lack of randomization and the heterogeneity of stage of disease between the two approaches. Furthermore, surgeon experience and the need for other specialists in advanced stages should also be investigated.

5. Robotic Pelvic Organ Prolapse Treatment

Pelvic organ prolapse (POP) is a common cause of morbidity in women with a remarkable impact on quality of life [45]. Surgery can offer a wide range of options to restore pelvic anatomy and function. The surgical approach depends on the surgeon’s experience, patient’s performance status, age, and patient comorbidity. The gold standard surgical treatment for grade 2–4 vaginal vault prolapse is sacrocolpopexy. Sacrocolpopexy superiority compared to other techniques, such as sacrospinous vaginal apex suspension, has been confirmed in a randomized clinical trial [46]. Furthermore, open abdominal sacrocolpopexy (ASC) is associated with optimal long-term outcomes.
However, the advent of MIS and its known advantages compared to open surgery made its application in POP surgery an issue of interest. In a randomized clinical trial by Freeman in 2013, non-inferiority of LPS vs. ASC in terms of perioperative outcomes and anatomic restoration according to the Pelvic Organ Prolapse Quantification System (POP-Q) were equivalent [47]. In addition, the robotic approach offers better visualization during dissection and easier suturing compared to LPS. As a consequence, RS may represent a feasible option for providing greater access to patients and surgeons to minimally invasive techniques due to a flatter learning curve [48]. Robotic and laparoscopic sacrocolpopexy has been compared in randomized clinical trials. Paraiso et al. enrolled 78 patients with 2–4 stage POP, 38 in the laparoscopic group, and 40 in the robotic group. Robotic sacrocolpopexy (RSC) was associated with longer operative time, increased postoperative pain, higher costs, and no benefits in terms of the anatomic and functional success of the technique after a one-year follow-up compared to laparoscopic sacrocolpopexy (LSC) [49].
Anger et al. randomized 78 patients with symptomatic POP to LSC and RSC. The primary outcome was to evaluate costs over the six weeks after surgery. Secondary outcomes were perioperative complications, postoperative pain, and clinical long-term outcomes after six months of follow-up. The results showed higher costs, longer operative time, and increased postoperative pain for the robotic approach with overlapping long-term outcomes compared to LSC. Researchers hypothesized that the lack of tactile feedback may hinder the surgeon’s control of pressure exerted on ports with a slight temporary increase in postoperative pain [50]. Furthermore, a high success rate for minimally invasive sacrocolpopexy was confirmed in an ancillary analysis after a one-year follow-up without differences between the two groups [51]. Illiano et al. in 2019 published a non-inferiority RCT comparing RSC to LSC for POP repair in patients with symptomatic POP-Q stage III-IV. Both arms showed excellent results with a 100% cure rate of apical compartment defect. RSC also showed a higher restoration rate of the anterior and posterior compartment compared to LSC but without statistical significance [52].
In a large retrospective trial published by Nosti et al. on 1124 patients (589 ASC vs. 273 LSC vs. 262 RSC), the open approach was associated with a higher rate of intraoperative and postoperative complications compared to minimally invasive sacrocolpopexy (MISC). MISC was associated with less blood loss, minor length of hospital stay, and longer operative time compared to ASC, especially in the robotic group. Furthermore, RSC patients experienced a minor rate of postoperative complications compared to LSC [53].
According to the available evidence, RSC may be considered a non-inferior alternative compared to LSC. The advantage provided by a flatter learning curve in the robotic approach may have value for surgeons with no experience in LPS. On the other hand, RS is associated with higher costs and longer operative times compared to LSC.

References

  1. Alletti, S.G.; Vizzielli, G.; Lafuenti, L.; Costantini, B.; Fagotti, A.; Fedele, C.; Cianci, S.; Perrone, E.; Gallotta, V.; Rossitto, C.; et al. Single-Institution Propensity-Matched Study to Evaluate the Psychological Effect of Minimally Invasive Interval Debulking Surgery Versus Standard Laparotomic Treatment: From Body to Mind and Back. J. Minim. Invasive Gynecol. 2018, 25, 816–822.
  2. Bellia, A.; Vitale, S.G.; Laganà, A.S.; Cannone, F.; Houvenaeghel, G.; Rua, S.; Ladaique, A.; Jauffret, C.; Ettore, G.; Lambaudie, E. Feasibility and surgical outcomes of conventional and robot-assisted laparoscopy for early-stage ovarian cancer: A retrospective, multicenter analysis. Arch. Gynecol. Obstet. 2016, 294, 615–622.
  3. Cianci, S.; Rosati, A.; Rumolo, V.; Gueli Alletti, S.; Gallotta, V.; Turco, L.C.; Corrado, G.; Vizzielli, G.; Fagotti, A.; Fanfani, F.; et al. Robotic Single-Port Platform in General, Urologic, and Gynecologic Surgeries: A Systematic Review of the Literature and Meta-analysis. World J. Surg. 2019, 43, 2401–2419.
  4. Gala, R.B.; Margulies, R.; Steinberg, A.; Murphy, M.; Lukban, J.; Jeppson, P.; Aschkenazi, S.; Olivera, C.; South, M.; Lowenstein; et al. Systematic review of robotic surgery in gynecology: Robotic techniques compared with laparoscopy and laparotomy. J. Minim. Invasive Gynecol. 2014, 21, 353–361.
  5. Nelson, G.; Bakkum-Gamez, J.; Kalogera, E.; Glaser, G.; Altman, A.; Meyer, L.A.; Taylor, J.S.; Iniesta, M.; Lasala, J.; Mena, G.; et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations-2019 update. Int. J. Gynecol. Cancer 2019, 29, 651–668.
  6. Alletti, S.G.; Perrone, E.; Fedele, C.; Cianci, S.; Pasciuto, T.; Chiantera, V.; Uccella, S.; Ercoli, A.; Vizzielli, G.; Fagotti, A.; et al. A Multicentric Randomized Trial to Evaluate the ROle of Uterine MANipulator on Laparoscopic/Robotic HYsterectomy for the Treatment of Early-Stage Endometrial Cancer: The Romanhy Trial. Front. Oncol. 2021, 11, 720894.
  7. Cianci, S.; Arcieri, M.; Vizzielli, G.; Martinelli, C.; Granese, R.; La Verde, M.; Fagotti, A.; Fanfani, F.; Scambia, G.; Ercoli, A. Robotic Pelvic Exenteration for Gynecologic Malignancies, Anatomic Landmarks, and Surgical Steps: A Systematic Review. Front. Surg. 2021, 8, 790152.
  8. Kim, S.; Luu, T.H.; Llarena, N.; Falcone, T. Role of robotic surgery in treating fibroids and benign uterine mass. Best Pract. Res. Clin. Obstet. Gynaecol. 2017, 45, 48–59.
  9. Munro, M.G.; Critchley, H.O.; Broder, M.S.; Fraser, I.S.; FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int. J. Gynaecol. Obstet. 2011, 113, 3–13.
  10. Seracchioli, R.; Rossi, S.; Govoni, F.; Rossi, E.; Venturoli, S.; Bulletti, C.; Flamigni, C. Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: A randomized comparison with abdominal myomectomy. Hum. Reprod. 2000, 15, 2663–2668.
  11. Advincula, A.P.; Xu, X.; Goudeau, S., 4th; Ransom, S.B. Robot-assisted laparoscopic myomectomy versus abdominal myomectomy: A comparison of short-term surgical outcomes and immediate costs. J. Minim. Invasive Gynecol. 2007, 14, 698–705.
  12. Bedient, C.E.; Magrina, J.F.; Noble, B.N.; Kho, R.M. Comparison of robotic and laparoscopic myomectomy. Am. J. Obstet Gynecol. 2009, 201, 566.e1–566.e5665.
  13. Nezhat, C.; Lavie, O.; Hsu, S.; Watson, J.; Barnett, O.; Lemyre, M. Robotic-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy—A retrospective matched control study. Fertil. Steril. 2009, 91, 556–559.
  14. Gargiulo, A.R.; Srouji, S.S.; Missmer, S.A.; Correia, K.F.; Vellinga, T.T.; Einarsson, J.I. Robot-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy. Obstet. Gynecol. 2012, 120 Pt 1, 284–291.
  15. Barakat, E.E.; Bedaiwy, M.A.; Zimberg, S.; Nutter, B.; Nosseir, M.; Falcone, T. Robotic-assisted, laparoscopic, and abdominal myomectomy: A comparison of surgical outcomes. Obstet. Gynecol. 2011, 117 Pt 1, 256–266.
  16. Gobern, J.M.; Rosemeyer, C.J.; Barter, J.F.; Steren, A.J. Comparison of robotic, laparoscopic, and abdominal myomectomy in a community hospital. JSLS J. Soc. Laparoendosc. Surg. 2013, 17, 116–120.
  17. Özbaşlı, E.; Güngör, M. Comparison of perioperative outcomes among robot-assisted, conventional laparoscopic, and abdominal/open myomectomies. J. Turk. Ger. Gynecol. Assoc. 2021, 22, 312–318.
  18. Flyckt, R.; Soto, E.; Nutter, B.; Falcone, T. Comparison of Long-Term Fertility and Bleeding Outcomes after Robotic-Assisted, Laparoscopic, and Abdominal Myomectomy. Obstet. Gynecol. Int. 2016, 2016, 2789201.
  19. Sizzi, O.; Rossetti, A.; Malzoni, M.; Minelli, L.; La Grotta, F.; Soranna, L.; Panunzi, S.; Spagnolo, R.; Imperato, F.; Landi, S.; et al. Italian multicenter study on complications of laparoscopic myomectomy. J. Minim. Invasive Gynecol. 2007, 14, 453–462.
  20. Goldberg, H.R.; McCaffrey, C.; Amjad, H.; Kives, S. Fertility and Pregnancy Outcomes After Robotic-assisted Laparoscopic Myomectomy in a Canadian Cohort. J. Minim. Invasive Gynecol. 2022, 29, 72–76.
  21. Albright, B.B.; Witte, T.; Tofte, A.N.; Chou, J.; Black, J.D.; Desai, V.; Erekson, E.A. Robotic Versus Laparoscopic Hysterectomy for Benign Disease: A Systematic Review and Meta-Analysis of Randomized Trials. J. Minim. Invasive Gynecol. 2016, 23, 18–27.
  22. Alletti, S.G.; Rossitto, C.; Cianci, S.; Perrone, E.; Pizzacalla, S.; Monterossi, G.; Vizzielli, G.; Gidaro, S.; Scambia, G. The Senhance™ surgical robotic system (“Senhance”) for total hysterectomy in obese patients: A pilot study. J. Robot. Surg. 2018, 12, 229–234.
  23. Geppert, B.; Lönnerfors, C.; Persson, J. Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: Surgical technique and comparison with open surgery. Acta Obstet. Gynecol. Scand. 2011, 90, 1210–1217.
  24. ACOG Committee. ACOG Committee Opinion No.444: Choosing the route of hysterectomy for benign disease. Obstet. Gynecol. 2009, 114, 1156–1158.
  25. Uccella, S.; Capozzi, V.A.; Ricco’, M.; Perrone, E.; Zanello, M.; Ferrari, S.; Zorzato, P.C.; Seracchioli, R.; Cromi, A.; Serati, M.; et al. Sexual Function following Laparoscopic versus Transvaginal Closure of the Vaginal Vault after Laparoscopic Hysterectomy: Secondary Analysis of a Randomized Trial by the Italian Society of Gynecological Endoscopy Using a Validated Questionnaire. J. Minim. Invasive Gynecol. 2020, 27, 186–194.
  26. Alletti, S.G.; Perrone, E.; Cretì, A.; Cianci, S.; Uccella, S.; Fedele, C.; Fanfani, F.; Palmieri, S.; Fagotti, A.; Scambia, G.; et al. Feasibility and perioperative outcomes of percutaneous-assisted laparoscopic hysterectomy: A multicentric Italian experience. Eur. J. Obstet. Gynecol. Reprod Biol. 2020, 245, 181–185.
  27. Cianci, S.; Perrone, E.; Rossitto, C.; Fanfani, F.; Tropea, A.; Biondi, A.; Scambia, G.; Gueli Alletti, S. Percutaneous-assisted vs mini-laparoscopic hysterectomy: Comparison of ultra-minimally invasive approaches. Updates Surg. 2021, 73, 2347–2354.
  28. Alletti, S.G.; Perrone, E.; Cianci, S.; Rossitto, C.; Monterossi, G.; Bernardini, F.; Scambia, G. 3 mm Senhance robotic hysterectomy: A step towards future perspectives. J. Robot. Surg. 2018, 12, 575–577.
  29. Aarts, J.W.; Nieboer, T.E.; Johnson, N.; Tavender, E.; Garry, R.; Mol, B.W.; Kluivers, K.B. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst. Rev. 2015, 2015, CD003677.
  30. Laganà, A.S.; Garzon, S.; Raffaelli, R.; Gullo, G.; Franchi, M. Robotic Surgery in Female-To-Male Transition: A Possible Way for Further Improvement. J. Investig. Surg. 2021, 34, 651–652.
  31. Nawfal, A.K.; Orady, M.; Eisenstein, D.; Wegienka, G. Effect of body mass index on robotic-assisted total laparoscopic hysterectomy. J. Minim. Invasive Gynecol. 2011, 18, 328–332.
  32. Wright, J.D.; Ananth, C.V.; Lewin, S.N.; Burke, W.M.; Lu, Y.S.; Neugut, A.I.; Herzog, T.J.; Hershman, D.L. Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease. JAMA 2013, 309, 689–698.
  33. Paraiso, M.F.R.; Ridgeway, B.; Park, A.J.; Park, A.J.; Jelovsek, J.E.; Barber, M.D.; Falcone, T.; Einarsson, J.I. A randomized trial comparing conventional and robotically assisted total laparoscopic hysterectomy. Am. J. Obstet Gynecol. 2013, 208, 368.e1–368.e3687.
  34. Sarlos, D.; Kots, L.; Stevanovic, N.; von Felten, S.; Schär, G. Robotic compared with conventional laparoscopic hysterectomy: A randomized controlled trial. Obstet. Gynecol. 2012, 120, 604–611.
  35. Lönnerfors, C.; Reynisson, P.; Persson, J. A randomized trial comparing vaginal and laparoscopic hysterectomy vs robot-assisted hysterectomy. J. Minim. Invasive Gynecol. 2015, 22, 78–86.
  36. Deimling, T.A.; Eldridge, J.L.; Riley, K.A.; Kunselman, A.R.; Harkins, G.J. Randomized controlled trial comparing operative times between standard and robot-assisted laparoscopic hysterectomy. Int. J. Gynaecol. Obstet. 2017, 136, 64–69.
  37. Cosentino, F.; Vizzielli, G.; Turco, L.C.; Fagotti, A.; Cianci, S.; Vargiu, V.; Zannoni, G.F.; Ferrandina, G.; Scambia, G. Near-Infrared Imaging with Indocyanine Green for Detection of Endometriosis Lesions (Gre-Endo Trial): A Pilot Study. J. Minim. Invasive Gynecol. 2018, 25, 1249–1254.
  38. Daraï, E.; Dubernard, G.; Coutant, C.; Frey, C.; Rouzier, R.; Ballester, M. Randomized trial of laparoscopically assisted versus open colorectal resection for endometriosis: Morbidity, symptoms, quality of life, and fertility. Ann. Surg. 2010, 251, 1018–1023.
  39. de Paula Andres, M.; Borrelli, G.M.; Kho, R.M.; Abrão, M.S. The current management of deep endometriosis: A systematic review. Minerva Ginecol. 2017, 69, 587–596.
  40. Magrina, J.F.; Espada, M.; Kho, R.M.; Cetta, R.; Chang, Y.H.; Magtibay, P.M. Surgical Excision of Advanced Endometriosis: Perioperative Outcomes and Impacting Factors. J. Minim. Invasive Gynecol. 2015, 22, 944–950.
  41. Nezhat, F.R.; Sirota, I. Perioperative outcomes of robotic assisted laparoscopic surgery versus conventional laparoscopy surgery for advanced-stage endometriosis. JSLS J. Soc. Laparoendosc. Surg. 2014, 18, e2014.00094.
  42. Nezhat, C.R.; Stevens, A.; Balassiano, E.; Soliemannjad, R. Robotic-assisted laparoscopy vs conventional laparoscopy for the treatment of advanced stage endometriosis. J. Minim. Invasive Gynecol. 2015, 22, 40–44.
  43. Soto, E.; Luu, T.H.; Liu, X.; Magrina, J.F.; Wasson, M.N.; Einarsson, J.I.; Cohen, S.L.; Falcone, T. Laparoscopy vs. Robotic Surgery for Endometriosis (LAROSE): A multicenter, randomized, controlled trial. Fertil. Steril. 2017, 107, 996–1002.e3.
  44. DuBeshter, B.; Angel, C.; Toy, E.; Thomas, S.; Glantz, J.C. Current Role of Robotic Hysterectomy. J. Gynecol. Surg. 2013, 29, 174–178.
  45. ACOG Committee; Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214. Obstet. Gynecol. 2019, 134, e126–e142.
  46. Maher, C.; Baessler, K.; Glazener, C.M.; Adams, E.J.; Hagen, S. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst. Rev. 2004, 4, CD004014.
  47. Freeman, R.M.; Pantazis, K.; Thomson, A.; Frappell, J.; Bombieri, L.; Moran, P.; Slack, M.; Scott, P.; Waterfield, M. A randomised controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. Int. Urogynecol. J. 2013, 24, 377–384.
  48. Akl, M.N.; Long, J.B.; Giles, D.L.; Cornella, J.L.; Pettit, P.D.; Chen, A.H.; Magtibay, P.M. Robotic-assisted sacrocolpopexy: Technique and learning curve. Surg. Endosc. 2009, 23, 2390–2394.
  49. Paraiso, M.F.R.; Jelovsek, J.E.; Frick, A.; Chen, C.C.G.; Barber, M.D. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: A randomized controlled trial. Obstet. Gynecol. 2011, 118, 1005–1013.
  50. Anger, J.T.; Mueller, E.R.; Tarnay, C.; Smith, B.; Stroupe, K.; Rosenman, A.; Brubaker, L.; Bresee, C.; Kenton, K. Robotic compared with laparoscopic sacrocolpopexy: A randomized controlled trial. Obstet. Gynecol. 2014, 123, 5–12.
  51. Kenton, K.; Mueller, E.R.; Tarney, C.; Bresee, C.; Anger, J.T. One-Year Outcomes After Minimally Invasive Sacrocolpopexy. Female Pelvic. Med. Reconstr. Surg. 2016, 22, 382–384.
  52. Illiano, E.; Ditonno, P.; Giannitsas, K.; De Rienzo, G.; Bini, V.; Costantini, E. Robot-assisted Vs. Laparoscopic Sacrocolpopexy for High-stage Pelvic Organ Prolapse: A Prospective, Randomized, Single-center Study. Urology 2019, 134, 116–123.
  53. Nosti, P.A.; Umoh, A.U.; Kane, S.; White, D.E.; Harvie, H.S.; Lowenstein, L.; Gutman, R.E. Outcomes of abdominal and minimally invasive sacrocolpopexy: A retrospective cohort study. Female Pelvic. Med. Reconstr. Surg. 2014, 20, 33–37.
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Subjects: Obstetrics & Gynaecology
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register : Vito Andrea Capozzi , Elisa Scarpelli ,
, Angela Celardo , Marco Torella , Stefano Cianci
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Update Date: 22 Apr 2022
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