GYNECOLOGY: REVIEW Open Access Rambam Maimonides Medical Journal Abbreviations: FDA, Food and Drug Administration; FIGO, International Federation of Gynecology and Obstetrics; MASH, mobile advanced surgical hospital; RCT, randomized clinical trial; SCX, sacrocolpopexy. Citation: Lauterbach R, Matanes E, Lowenstein L. Review of Robotic Surgery in Gynecology—The Future Is Here. Rambam Maimonides Med J 2017;8 (2):e0019. Review. doi:10.5041/RMMJ.10296 Copyright: © 2017 Lauterbach et al. This is an open-access article. All its content, except where otherwise noted , is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conflict of interest: No potential conflict of interest relevant to this article was reported. * To whom correspondence should be addressed. E-mail:
[email protected] Rambam Maimonides Med J | www.rmmj.org.il 1 April 2017 Volume 8 Issue 2 e0019 Special Issue on Gynecology, Fertility, and Obstetrics Guest Editors: Lior Lowenstein, M.D., M.S., M.H.A., Shahar Kol, M.D., and Zeev Weiner, M.D. Review of Robotic Surgery in Gynecology—The Future Is Here Roy Lauterbach, M.D.*, Emad Matanes, M.D., and Lior Lowenstein, M.D., M.S., M.H.A. Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel; and Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel ABSTRACT The authors present a systematic review of randomized and observational, retrospective and prospective studies to compare between robotic surgery as opposed to laparoscopic, abdominal, and vaginal surgery for the treatment of both benign and malignant gynecologic indications. The comparison focuses on operative times, surgical outcomes, and surgical complications associated with the various surgical techniques. PubMed was the main search engine utilized in search of study data. The review included studies of various designs that included at least 25 women who had undergone robotic gynecologic surgery. Fifty-five studies (42 comparative and 13 non-comparative) met eligibility criteria. After careful analysis, we found that robotic surgery was consistently connected to shorter post-surgical hospitalizationwhen compared to open surgery, a difference less significant when compared to laparoscopic surgery. Also, it seems that robotic surgery is highly feasible in gynecology. There are quite a few inconsistencies regarding operative times and estimated blood loss between the different approaches, though in the majority of studies estimated blood loss was lower in the robotic surgery group. The high variance in operative times resulted from the difference in surgeon’s experience. The decision whether robotic surgery should become mainstream in gynecological surgery or remain another surgical technique in the gynecological surgeon’s toolbox requires DECEMBER 2019 | The Surgical Technologist | 567