Robot-assisted surgery:--impact on gynaecological and pelvic floor reconstructive surgery

The da Vinci Surgical System dominates robotic surgery, as the only robotic device to have FDA approval in gynaecology. The benefits of robot-assisted surgery include decreased length of stay, decreased blood loss and analgesic requirements. Ergonomic improvements allow the surgeon to operate with less risk of neck and back injury. Unfortunately the initial economic impact of purchasing and maintaining a robot are great but must be balanced with the potential savings from reduced length of stay and earlier return to normal activity. This review looks at the uses for the robot in both gynaecology and urogynaecology, assessing the efficacy of this modality compared to both straight stick (laparoscopy) and open procedures. We assess the benefits to both patient and surgeon from the available literature. Within the current economic environment we appraise the costs associated with the robot.