A systematic review and meta-analysis of conventional laparoscopic sacrocolpopexy versus robot-assisted laparoscopic sacrocolpopexy

Int J Gynaecol Obstet. 2016 Mar;132(3):284-91. doi: 10.1016/j.ijgo.2015.08.008. Epub 2015 Dec 9.

Abstract

Background: Robot-assisted laparoscopic sacrocolpopexy (RALSC) has spread rapidly without the availability of comprehensive and systematically recorded outcome data.

Objective: To systematically review and compare the outcomes of laparoscopic sacrocolpopexy (LSC) and RALSC.

Search strategy: PubMed and Scopus were searched for reports published from 2000 to 2014, using the search terms "robotic sacrocolpopexy," "laparoscopic sacrocolpopexy," and "sacral colpopexy."

Selection criteria: Studies were included if they directly compared the outcomes of RALSC and LSC, the sample size in each group was more than 15, the follow-up duration was longer than 3 months, and the report was in English.

Data collection and analysis: The studies' characteristics, quality, and outcomes were recorded. Random-/fixed-effects models were used to combine data.

Main results: Data on 264 RALSC and 267 LSC procedures were collected from seven studies. The mean operative time was longer in the RALSC group (245.9 minutes vs 205.9 minutes; P<0.001). The estimated blood loss in the two groups was similar (114.4 mL vs 160.1 mL; P=0.36). The differences in incidence of intraoperative/postoperative complications were also similar (P=0.85 vs P=0.92). The costs of RALSC were significantly higher than were those of LSC series in each of three studies (P<0.01 for all).

Conclusions: The clinical outcomes of prolapse surgery are similar with RALSC and LSC, but RALSC is less efficient in terms of cost and time.

Keywords: Laparoscopy; Pelvic organ prolapse; Robotics; Sacrocolpopexy.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Female
  • Gynecologic Surgical Procedures / adverse effects
  • Gynecologic Surgical Procedures / economics
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Operative Time*
  • Patient Satisfaction / statistics & numerical data
  • Pelvic Organ Prolapse / surgery*
  • Postoperative Complications*
  • Randomized Controlled Trials as Topic
  • Robotic Surgical Procedures / economics
  • Robotic Surgical Procedures / methods*
  • Surgical Mesh
  • Treatment Outcome
  • Vagina / surgery