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Robotic Gynecologic Surgery

Visco, Anthony G. MD1; Advincula, Arnold P. MD2

doi: 10.1097/AOG.0b013e31818f3c17
Clinical Expert Series
Expert Discussion

The objective of this article is to review the recent adoption, experience, and applications of robot-assisted laparoscopy in gynecologic surgery. The use of robotics in gynecologic surgery is increasing in the United States. Robotic-assisted laparoscopic surgeries in gynecology include benign hysterectomy, myomectomy, tubal reanastomoses, radical hysterectomy, lymph node dissections, and sacrocolpopexies. The majority of the current literature includes case series of various robotic surgeries. Recently, comparative retrospective and prospective studies have demonstrated the feasibility of this particular type of surgery. Although individual studies vary, robot-assisted gynecologic surgery is often associated with longer operating room time but generally similar clinical outcomes, decreased blood loss, and shorter hospital stay. Robot-assisted gynecologic surgery will likely continue to develop as more gynecologic surgeons are trained and more patients seek minimally invasive surgical options. Well-designed, prospective studies with well-defined clinical, long-term outcomes, including complications, cost, pain, return to normal activity, and quality of life, are needed to fully assess the value of this new technology.

Robot-assisted laparoscopy has several applications in gynecologic surgery, including simple and radical hysterectomy, lymph node dissection, tubal reanastomosis, myomectomy, and sacrocolpopexy.

From the 1Division of Urogynecology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; and 2Minimally Invasive Surgery Program, Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor, Michigan.

Continuing medical education is available online at www.greenjournal.org

See related editorial on page 1198.

Corresponding author: Anthony G. Visco, MD, Associate Professor and Chief, Division of Urogynecology and Reconstructive Pelvic Surgery, Director of Gynecologic Robotic Surgery, Vice Chair for Gynecologic Surgical Services, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710; e-mail: anthony.visco@duke.edu.

Financial Disclosure Dr. Visco is a consultant for Intuitive Surgical (Sunnyvale, CA). Dr. Advincula Is a consultant for Intuitive Surgical, Gyrus/ACMI (Southborough, MA), and SurgRx (Redwood City, CA).

© 2008 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.