[Robotic-assisted pelvic and renal surgery - an overview]

Area of Science:

• Surgical innovation
• Minimally invasive techniques
• Oncology

Background:

• Robotic-assisted surgery (RAS) is increasingly adopted in various surgical fields.
• Comparisons with traditional laparoscopic and open surgery are essential for understanding its value.
• Existing research suggests RAS offers benefits but also presents challenges.

Purpose of the Study:

• To evaluate the oncologic and functional outcomes of robotic-assisted surgery.
• To compare RAS with laparoscopic and open surgery.
• To identify the advantages and disadvantages of RAS in current clinical practice.

Main Methods:

• Systematic review of current studies comparing robotic-assisted surgery with laparoscopic and open surgery.
• Analysis of oncologic outcomes, functional results, blood loss, postoperative complications, and operative time.
• Assessment of ergonomic factors, learning curve effects, cost-effectiveness, and potential risks.

Main Results:

• Robotic-assisted surgery demonstrates non-inferior oncologic and functional outcomes compared to laparoscopic or open surgery.
• A potential exception is uterine cervix cancer, where survival outcomes may be less favorable after minimally invasive approaches.
• RAS is associated with reduced bleeding and lower transfusion rates, with similar postoperative complication rates to other methods.

Conclusions:

• Robotic-assisted surgery offers significant benefits, including improved ergonomics and reduced blood loss.
• Further research is needed to fully understand the surgical learning curve and optimize cost-effectiveness.
• While generally comparable, specific oncologic indications like uterine cervix cancer require careful consideration regarding surgical approach.