Weinberg Lori, Rao Sanjay, Escobar Pedro F
Department of OB/GYN and Women's Health Institute, Cleveland Clinic, Desk A-81, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Obstet Gynecol Int. 2011;2011:852061. doi: 10.1155/2011/852061. Epub 2011 Nov 28.
The introduction of da Vinci Robotic Surgery to the field of Gynecology has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. In general gynecology and reproductive gynecology, the robot is being increasingly used for procedures such as hysterectomies, myomectomies, adnexal surgery, and tubal anastomosis. Among urogynecology the robot is being utilized for sacrocolopexies. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomies and lymphadenectomies in oncologic diseases. Despite the rapid and widespread adoption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. Our aim is to update previously published reviews with a focus on only comparative observational studies. We determined that, with the right amount of training and skill, along with appropriate patient selection, robotic surgery can be highly advantageous. Patients will likely have less blood loss, less post-operative pain, faster recoveries, and fewer complications compared to open surgery and potentially even laparoscopy. However, until larger, well-designed observational studies or randomized control trials are completed which report long-term outcomes, we cannot definitively state the superiority of robotic surgery over other surgical methods.
达芬奇机器人手术引入妇科领域后，手术管理发生了巨大变化。机器人平台使经验较少的腹腔镜外科医生能够进行更复杂的手术。在普通妇科和生殖妇科中，机器人越来越多地用于子宫切除术、肌瘤切除术、附件手术和输卵管吻合术等手术。在泌尿妇科领域，机器人被用于骶骨固定术。在妇科肿瘤学领域，机器人越来越多地用于肿瘤疾病的子宫切除术和淋巴结清扫术。尽管机器人手术在妇科中迅速广泛应用，但尚无随机试验将其疗效和安全性与其他传统手术方法进行比较。我们的目的是更新之前发表的综述，重点关注仅有的比较观察性研究。我们确定，通过适量的培训和技能，以及适当的患者选择，机器人手术可能具有很大优势。与开放手术甚至可能与腹腔镜手术相比，患者可能失血更少、术后疼痛更少、恢复更快且并发症更少。然而，在完成更大规模、设计良好的观察性研究或随机对照试验并报告长期结果之前，我们无法明确说明机器人手术优于其他手术方法。
