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Chapter-40 The Evolving Role of Robotics in Reproductive Gynecologic Surgery

BOOK TITLE: State of the Art Atlas of Endoscopic Surgery in Infertility and Gynecology

Author
1. Advincula Arnold P
ISBN
9788184489903
DOI
10.5005/jp/books/11190_40
Edition
2/e
Publishing Year
2010
Pages
6
Author Affiliations
1. University of Central Florida College of Medicine Medical Director, Gynecologic Robotics Florida Hospital, Celebration Health, University of Michigan Medical Center, L 4000 Women’s Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109
Chapter keywords

Abstract

Although today’s robotic surgical platform has definite advantages over conventional laparoscopy, limitations still exist. Some of these limitations revolve around the lack of haptic feedback and the overall bulky nature of the surgical system. High costs remain a significant obstacle to the more widespread use of robotics both domestically and internationally. Training protocols as well as credentialing and privileging must be better clarified across institutions. Although learning curves have been described for robotic procedures such as benign and oncologic hysterectomy, data still lack in the area of fertility-sparing reproductive surgery. As advancements continue in the area of robotics, critical appraisal must remain a high priority. The authors concluded that in the hands of a skilled laparoscopic surgeon, the robotic approach did not confer any major advantages. The second study by Kho et al retrospectively compared 40 robotic patients with 41 traditional laparoscopic myomectomy patients. Similarly, the authors found short-term surgical outcomes to be similar between the two groups. Long-term outcomes such as pregnancy were not assessed. The existing data regarding the application of robotics to reproductive surgery appears extremely promising. Although long-term studies are lacking in the areas of tubal surgery and myomectomy, short-term outcomes are at least comparable to if not better than traditional laparotomic and conventional laparoscopic routes. Increasing experience with this technology will allow for improved data collection and assessment of long-term surgical outcomes which are clearly needed. Additional areas of application such as endometriosis resection and Müllerian anomaly treatment will be better elucidated as the technology evolves.

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