Five-year use of robotic surgery in operative gynecology: summary and prospects

Objective. To study the experience with robot-assisted surgical interventions performed at the Moscow Regional Research Institute of Obstetrics and Gynecology in 2013 to 2018. Subjects and methods. A total of 594 operations were performed during the reporting period. The patients were divided into 3 groups. Group 1 consisted of patients with benign gynecological diseases (infiltrative endometriosis and recurrent genital prolapse) who had been operated on using the surgical complex. Groups 2 and 3 included patients with obvious morbid obesity and malignant endometrial diseases, who were at high surgical risk. Results. In patients with infiltrative endometriosis, the pregnancy rate was 45.16%, which was comparable with that in the control laparoscopic group. In patients with prolapse, the disadvantage of robotic sacrocolpopexy was only additional time required to install the patient’s console (docking). Anatomical and functional results were comparable with those in the laparoscopic group. In patients with morbid obesity, the complication rate in the robot-assisted laparoscopy group was 3.8%, which was significantly lower than that in the laparoscopic group. Conclusion. Robot-assisted surgery has obvious advantages in the surgical treatment of complex gynecological diseases, not only malignant, but also benign, primarily the concomitant forms of severe infiltrative endometriosis (in certain situations that substantially affect the restoration of reproductive function in the patient).

robotic surgery, deep infiltrative endometriosis, sacrocolpopexy, morbid obesity