Oliveira Marco Aurelio Pinho, Raymundo Thiers Soares, Pereira Thiago Dantas, Souza Ricardo José de, Lima Felipe Vaz, De Wilde Rudy Leon, Brollo Leila Cristina
Department of Gynecology, State University of Rio de Janeiro, Rio de Janeiro 20551-030, Brazil.
Department of Gynecology, Cardoso Fontes Federal Hospital, Rio de Janeiro 22745-130, Brazil.
J Clin Med. 2023 Aug 21;12(16):5416. doi: 10.3390/jcm12165416.
Women with bladder endometriosis often present with more advanced stages of endometriosis. Robotic surgery has emerged as a promising approach to the management of bladder endometriosis. This systematic review aims to analyze the current literature on robotic surgery for bladder endometriosis and describe our systematic approach to surgical treatment.
This review followed the PRISMA guidelines, which ensured a comprehensive and transparent approach to selecting and evaluating relevant studies. We conducted a thorough literature search to identify studies that investigated the use of robotic surgery for bladder endometriosis. Relevant databases were searched, and inclusion and exclusion criteria were applied to select eligible studies. Data extraction and analysis were performed to assess the outcomes and effectiveness of robotic surgery for the treatment of bladder endometriosis.
We did not find any randomized clinical trials with the use of robotics in the treatment of bladder endometriosis. We found only two retrospective studies comparing robotic surgery with laparoscopy, and another retrospective study comparing robotic surgery, laparoscopy, and laparotomy in the treatment of bladder endometriosis. All the other 12 studies were solely case reports. Despite the lack of robust evidence in the literature, the studies demonstrated that robotic surgery is feasible and is associated with reduced postoperative pain, shorter hospital stays, and faster recovery.
The utilization of robotic technology is a promising option for the surgical management of bladder endometriosis. We advocate a surgical systematic approach for the robotic treatment of bladder endometriosis. Robotic technology, with its 3D vision, instrumental degrees of freedom, and precision, particularly in suturing, may provide potential benefits over traditional laparoscopy.
膀胱子宫内膜异位症女性患者的子宫内膜异位症往往处于更晚期阶段。机器人手术已成为治疗膀胱子宫内膜异位症的一种有前景的方法。本系统评价旨在分析当前关于机器人手术治疗膀胱子宫内膜异位症的文献，并描述我们的手术治疗系统方法。
本评价遵循PRISMA指南，确保在选择和评估相关研究时采用全面且透明的方法。我们进行了全面的文献检索，以确定研究机器人手术治疗膀胱子宫内膜异位症的研究。检索了相关数据库，并应用纳入和排除标准来选择符合条件的研究。进行了数据提取和分析，以评估机器人手术治疗膀胱子宫内膜异位症的结果和有效性。
我们未找到任何使用机器人技术治疗膀胱子宫内膜异位症的随机临床试验。我们仅发现两项比较机器人手术与腹腔镜手术的回顾性研究，以及另一项比较机器人手术、腹腔镜手术和剖腹手术治疗膀胱子宫内膜异位症的回顾性研究。其他12项研究均为病例报告。尽管文献中缺乏有力证据，但这些研究表明机器人手术是可行的，且与术后疼痛减轻、住院时间缩短和恢复更快相关。
机器人技术的应用是膀胱子宫内膜异位症手术治疗的一个有前景的选择。我们提倡采用手术系统方法进行机器人治疗膀胱子宫内膜异位症。机器人技术凭借其3D视觉、器械自由度和精确性，尤其是在缝合方面，可能比传统腹腔镜手术具有潜在优势。
