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Robot-assisted laparoscopic surgery in gynecology: scientific dream or reality?
Camran Nezhat1, Ofer Lavie, Madeleine Lemyre
1Center for Special Minimally Invasive Surgery, Stanford University Medical Center, Palo Alto, California, USA. cnezhat@stanford.edu
Objective:
To analyze the feasibility, safety, advantages, and disadvantages of using robotic technology for gynecologic surgeries in a large group of patients.
Design:
Retrospective study (Canadian Task Force classification II-3).
Setting:
Tertiary endoscopic referral centers.
Patient(S):
Eighty-seven patients requiring laparoscopic treatments for benign gynecologic conditions.
Intervention(S):
Charts reviewed from robotic-assisted gynecologic operative laparoscopies.
Main Outcome Measure(S):
Length of surgery, time for robot assembly and disassembly, rate of conversion to laparotomies, and complications.
Result(S):
Between January 2006 and August 2007, 137 robotically assisted gynecologic procedures were performed in 87 patients. The da Vinci Surgical System was used. The average length of the surgeries was 205 minutes (60-420 minutes). Assembly of the robot lasted 16 minutes (10-27 minutes) when disassembly took 2.5 minutes (2-6 minutes). There were no conversions to laparotomy. There were three complications.
Conclusion(S):
Robotic-assisted technology, in its present state, is enabling more surgeons to perform endoscopic surgery. Its advantages are 3D Vision and a faster learning curve for suturing and operating while sitting. It's an exciting enabling technology with a great future.
