Robotic-assisted Versus Conventional Laparoscopic Hysterectomy for Benign Gynecological Conditions: A Systematic Review and Meta-analysis

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A BSTRACT

Background:

Minimally invasive gynecologic surgery is safe and feasible procedure for benign gynaecological conditions with less morbidity.

Objective:

To determine the best approach in benign gynecology and establish superiority of robotic over conventional laparoscopic hysterectomy in terms of safety and effectiveness.

Methods:

Search strategy: Electronic databases: MEDLINE, Embase, CENTRAL (the Registry of Controlled Clinical Studies of the Cochrane Collaboration), Google scholar, Pubmed and Scopus were searched from 2010-2022. Selection criteria: All randomized controlled trials and quasi-randomised trials which compared robotic versus conventional laparoscopic hysterectomy were included to conduct this systematic review and meta-analysis to investigate compared to traditional approaches.

Results:

Only five RCTs (326 patients in total) comparing robotic and conventional laparoscopic hysterectomy were included after a comprehensive literature search. Results of our analysis showed no clear benefit in any of the two techniques in operating time, estimated blood loss, length of hospital stay and overall complications.

Conclusion:

This systematic review suggests no statistical difference in surgical and patient outcomes between robotic and conventional laparoscopic hysterectomy relating to OT, EBL, LOHS, overall complications, and survival.

Related collections

Most cited references 19

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Is Open Access

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2027)

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.

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Record: found
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RoB 2: a revised tool for assessing risk of bias in randomised trials

Jonathan A C Sterne, Jelena Savović, Matthew J L Page … (2023)

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Imputing missing standard deviations in meta-analyses can provide accurate results.

Toshi Furukawa, Corrado Barbui, Corrado Barbui … (2006)

Many reports of randomized controlled trials (RCTs) fail to provide standard deviations (SDs) of their continuous outcome measures. Some meta-analysts substitute them by those reported in other studies, either from another meta-analysis or from other studies in the same meta-analysis. But the validity of such practices has never been empirically examined. We compared the actual standardized mean difference (SMD) of individual RCTs and the meta-analytically pooled SMD of all RCTs against those based on the above-mentioned two imputation methods in two meta-analyses of antidepressants. Two meta-analyses included 39 RCTs of fluoxetine (n = 3,681) and 25 RCTs of amitriptyline (n = 1,832), which had actually reported means and SDs of the Hamilton Rating Scale for Depression. According to either of the two proposed imputation methods, the agreement between actual SMDs and imputed SMDs for individual RCTs was very good with ANOVA intraclass correlation coefficients between 0.61 and 0.97. The agreement between the actual pooled SMD and the imputed one was even better, with minimal differences in both their point estimates and 95% confidence intervals. For a systematic review where some of the identified trials do not report SDs, it appears safe to borrow SDs from other studies.

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Author and article information

Journal

Journal ID (nlm-ta): J Midlife Health

Journal ID (iso-abbrev): J Midlife Health

Journal ID (publisher-id): JMH

Journal ID (publisher-id): J Mid-life Health

Title: Journal of Mid-Life Health

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 0976-7800

ISSN (Electronic): 0976-7819

Publication date (Print): Apr-Jun 2024

Publication date (Electronic): 05 July 2024

Volume: 15

Issue: 2

Pages: 91-98

Affiliations

[1]Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

[1 ]Department of Biostatistics, All India Institute of Medical Sciences, Delhi, India

Author notes

Address for correspondence: Dr. Rajlaxmi Mundhra, Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India. E-mail: rmundhra54@ 123456yahoo.com

Article

Publisher ID: JMH-15-91

DOI: 10.4103/jmh.jmh_235_23

PMC ID: 11321512

PubMed ID: 39145271

SO-VID: 75256ed4-8145-41a9-8cd4-b8c111086545

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

History

Date received : 29 November 2023

Date revision received : 18 January 2024

Date accepted : 18 March 2024

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