Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework

Aims This review aims to evaluate the feasibility of robot-assisted laparoscopic surgery (RALS) as an alternative to standard laparoscopic surgery (SLS) for the treatment of bowel deep-infiltrative endometriosis. Additionally, it aims to provide guidance for future study design, by gaining insight i...

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Bibliographic Details
Published in:International journal of colorectal disease 2024-06, Vol.39 (1), p.98, Article 98
Main Authors: Ong, Hwa Ian, Shulman, Nastassia, Nugraha, Patrick, Wrenn, Stephen, Nally, Deirdre, Peirce, Colin, Mahmood, Uzma, McCormick, Jacob, Proud, David, Warrier, Satish, Fleming, Christina, Mohan, Helen
Format: Article
Language:English
Subjects:
Clinical trials
Complications
Endometriosis
Gastroenterology
Hepatology
Internal Medicine
Intestine
Laparoscopy
Medicine
Medicine & Public Health
Patients
Postoperative
Proctology
Review
Robotic surgery
Surgery
Systematic review
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Summary:Aims This review aims to evaluate the feasibility of robot-assisted laparoscopic surgery (RALS) as an alternative to standard laparoscopic surgery (SLS) for the treatment of bowel deep-infiltrative endometriosis. Additionally, it aims to provide guidance for future study design, by gaining insight into the current state of research, in accordance with the IDEAL framework. Method A systematic review was conducted to identify relevant studies on RALS for bowel deep infiltrating endometriosis in Medline, Embase, Cochrane Library and PubMed databases up to August 2023 and reported in keeping with PRISMA guidelines. The study was registered with PROSPERO Registration: CRD42022308611 Results Eleven primary studies were identified, encompassing 364 RALS patients and 83 SLS patients, from which surgical details, operative and postoperative outcomes were extracted. In the RALS group, mean operating time was longer (235 ± 112 min) than in the standard laparoscopy group (171 ± 76 min) ( p < 0.01). Patients in the RALS group experienced a shorter hospital stay (5.3 ± 3.5 days vs. 7.3 ± 4.1 days) ( p < 0.01), and appeared to have fewer postoperative complications compared to standard laparoscopy. Research evidence for RALS in bowel DE is at an IDEAL Stage 2B of development. Conclusion RALS is a safe and feasible alternative to standard laparoscopy for bowel endometriosis treatment, with a shorter overall length of stay despite longer operating times. Further robust randomized trials recommended to delineate other potential advantages of RALS.
ISSN:1432-1262
0179-1958
1432-1262
DOI:10.1007/s00384-024-04669-w