New technologies in the surgical management of endometriosis
DOI:
https://doi.org/10.33393/ao.2023.2547Keywords:
Deep endometriosis, Endometriosis, Indocyanine green, Laparoscopy, Robotic surgery, Surgical treatmentAbstract
Introduction: Endometriosis is a very common disease that affects up to 10% of the female population. Although medical therapy represents the first-line treatment for endometriosis, it does not always manage to control symptoms. Laparoscopy represents the standard surgical treatment in endometriosis. Robotic-assisted laparoscopy is an innovative mini-invasive surgical technique. Its application in gynecological surgery and in endometriosis has increased in the last decade. Our purpose is to offer an overview of the role of robotic-assisted laparoscopy in the surgical treatment of endometriosis.
Methods: We evaluated studies dealing with the new technique in surgery for endometriosis with a focus on robotic surgery. We performed a compressive literature research on PubMed and the Cochrane Library in December 2022.
Expert opinion: Robotic-assisted surgery is a feasible and safe approach to endometriosis surgery and is superimposable to laparoscopy in terms of complication rate, blood loss, hospitalization, and long-term improvement of symptoms.
The effect of robotic-assisted surgery on operative time is still contradictory and needs to be further investigated. Robotic-assisted laparoscopic surgery can provide particular benefit in the management of women with severe endometriosis secondary to its advantage in surgical precision and ergonomics.
Indocyanine green fluorescence angiography could be useful to assist in the vascularization of ureters and bowel anastomosis, to prevent postoperative complication and leakage.
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References
Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat Rev Dis Primers. 2018;4(1):9. https://doi.org/10.1038/s41572-018-0008-5 PMID:30026507 DOI: https://doi.org/10.1038/s41572-018-0008-5
Becker CM, Bokor A, Heikinheimo O, et al; ESHRE Endometriosis Guideline Group. ESHRE guidelines: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009. https://doi.org/10.1093/hropen/hoac009 PMID:35350465 DOI: https://doi.org/10.1093/hropen/hoac009
Bafort C, Beebeejaun Y, Tomassetti C, Bosteels J, Duffy JM. Laparoscopic surgery for endometriosis. Cochrane Gynaecology and Fertility Group, editor. Cochrane Database of Systematic Reviews [Internet]. 2020 Oct 23 [cited 2022 Nov 14];10(10): CD011031. Available from: http://doi.wiley.com/10.1002/14651858.CD011031.pub3 PMID: 33095458 DOI: https://doi.org/10.1002/14651858.CD011031.pub3
Revised American Fertility Society Classification of Endometriosis. Revised American Fertility Society classification of endometriosis: 1985. Fertil Steril. 1985;43(3):351-352. https://doi.org/10.1016/S0015-0282(16)48430-X PMID:3979573 DOI: https://doi.org/10.1016/S0015-0282(16)48430-X
Restaino S, Mereu L, Finelli A, et al. Robotic surgery vs laparoscopic surgery in patients with diagnosis of endometriosis: a systematic review and meta-analysis. J Robot Surg. 2020;14(5):687-694. https://doi.org/10.1007/s11701-020-01061-y PMID:32146573 DOI: https://doi.org/10.1007/s11701-020-01061-y
Arcoverde FVL, Andres MP, Borrelli GM, Barbosa PA, Abrão MS, Kho RM. Surgery for endometriosis improves major domains of quality of life: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2019;26(2):266-278. https://doi.org/10.1016/j.jmig.2018.09.774 PMID:30244153 DOI: https://doi.org/10.1016/j.jmig.2018.09.774
Angioni S, Peiretti M, Zirone M, et al. Laparoscopic excision of posterior vaginal fornix in the treatment of patients with deep endometriosis without rectum involvement: surgical treatment and long-term follow-up. Hum Reprod. 2006;21(6):1629-1634. https://doi.org/10.1093/humrep/del006PMID:16495305 DOI: https://doi.org/10.1093/humrep/del006
Minelli L, Fanfani F, Fagotti A, et al. Laparoscopic colorectal resection for bowel endometriosis: feasibility, complications, and clinical outcome. Arch Surg. 2009;144(3):234-239. https://doi.org/10.1001/archsurg.2008.555 PMID:19289662 DOI: https://doi.org/10.1001/archsurg.2008.555
Vercellini P, Somigliana E, Viganò P, Abbiati A, Barbara G, Crosignani PG. Surgery for endometriosis-associated infertility: a pragmatic approach. Hum Reprod. 2009;24(2):254-269. https://doi.org/10.1093/humrep/den379 PMID:18948311 DOI: https://doi.org/10.1093/humrep/den379
Gale J, Singh SS. A practical approach to fertility considerations in endometriosis surgery. Obstet Gynecol Clin North Am. 2022;49(2):241-256. https://doi.org/10.1016/j.ogc.2022.02.007PMID:35636806 DOI: https://doi.org/10.1016/j.ogc.2022.02.007
Vercellini P, Barbara G, Somigliana E. Which treatments are effective for endometriosis-related infertility? Fertil Steril. 2020;113(2):328-329. https://doi.org/10.1016/j.fertnstert.2019.10.019 PMID:32106979 DOI: https://doi.org/10.1016/j.fertnstert.2019.10.019
Moon AS, Garofalo J, Koirala P, Vu MT, Chuang L. Robotic surgery in gynecology. Surg Clin North Am. 2020;100(2):445-460. https://doi.org/10.1016/j.suc.2019.12.007 PMID:32169189 DOI: https://doi.org/10.1016/j.suc.2019.12.007
Cela V, Obino ME, Sergiampietri C, et al. The role of robotics in the management of endometriosis. Minerva Ginecol. 2017;69(5):504-516. Accessed November 14, 2022. https://www.minervamedica.it/index2.php?show=R09Y2017N05A0504 PMID:28271700
Lawrie TA, Liu H, Lu D, et al. Robot-assisted surgery in gynaecology. Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Group, editor. Cochrane Database of Systematic Reviews [Internet]. 2019 Apr 15 [cited 2022 Nov 14]; 4(4):CD011422 . Available from: https://doi.org/10.1002/14651858.CD011422.pub2 PMID: 30985921 DOI: https://doi.org/10.1002/14651858.CD011422.pub2
Nezhat C, Saberi NS, Shahmohamady B, Nezhat F. Robotic-assisted laparoscopy in gynecological surgery. JSLS. 2006;10(3):317-320. PMID:17212887
Mosbrucker C, Somani A, Dulemba J. Visualization of endometriosis: comparative study of 3-dimensional robotic and 2-dimensional laparoscopic endoscopes. J Robot Surg. 2018;12(1):59-66. https://doi.org/10.1007/s11701-017-0686-0 PMID:28255736 DOI: https://doi.org/10.1007/s11701-017-0686-0
Nagendran M, Gurusamy KS, Aggarwal R, Loizidou M, Davidson BR. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Hepato-Biliary Group, editor. Cochrane Database of Systematic Reviews [Internet]. 2013 Aug 27 [cited 2022 Nov 13]; 2013(8): CD006575. Available from: https://doi.org/10.1002/14651858.CD006575.pub3 PMID: 23980026. DOI: https://doi.org/10.1002/14651858.CD006575.pub3
Carvalho L, Abrão MS, Deshpande A, Falcone T. Robotics as a new surgical minimally invasive approach to treatment of endometriosis: a systematic review. Int J Med Robot. 2012;8(2):160-165. https://doi.org/10.1002/rcs.451 PMID:22162096 DOI: https://doi.org/10.1002/rcs.451
Soto E, Luu TH, Liu X, et al. Laparoscopy vs. Robotic Surgery for Endometriosis (LAROSE): a multicenter, randomized, controlled trial. Fertil Steril. 2017;107(4):996-1002.e3. https://doi.org/10.1016/j.fertnstert.2016.12.033 PMID:28238489 DOI: https://doi.org/10.1016/j.fertnstert.2016.12.033
Chen SH, Li ZA, Du XP. Robot-assisted versus conventional laparoscopic surgery in the treatment of advanced stage endometriosis: a meta-analysis. Clin Exp Obstet Gynecol. 2016;43(3):422-426. https://doi.org/10.12891/ceog3133.2016 PMID:27328505 DOI: https://doi.org/10.12891/ceog3133.2016
Siesto G, Ieda N, Rosati R, Vitobello D. Robotic surgery for deep endometriosis: a paradigm shift. Int J Med Robot. 2014;10(2):140-146. https://doi.org/10.1002/rcs.1518 PMID:23766030 DOI: https://doi.org/10.1002/rcs.1518
Liu C, Perisic D, Samadi D, Nezhat F. Robotic-assisted laparoscopic partial bladder resection for the treatment of infiltrating endometriosis. J Minim Invasive Gynecol. 2008;15(6):745-748. https://doi.org/10.1016/j.jmig.2008.07.002 PMID:18971140 DOI: https://doi.org/10.1016/j.jmig.2008.07.002
Raimondo D, Alboni C, Orsini B, et al. Comparison of perioperative outcomes between standard laparoscopic and robot-assisted approach in patients with rectosigmoid endometriosis. Acta Obstet Gynecol Scand. 2021;100(9):1740-1746. https://doi.org/10.1111/aogs.14170PMID:33999408 DOI: https://doi.org/10.1111/aogs.14170
Magrina JF, Espada M, Kho RM, Cetta R, Chang YHH, Magtibay PM. Surgical excision of advanced endometriosis: perioperative outcomes and impacting factors. J Minim Invasive Gynecol. 2015;22(6):944-950. https://doi.org/10.1016/j.jmig.2015.04.016 PMID:25917276 DOI: https://doi.org/10.1016/j.jmig.2015.04.016
Bedaiwy MA, Rahman MY, Chapman M, et al. Robotic-assisted hysterectomy for the management of severe endometriosis: a retrospective review of short-term surgical outcomes. JSLS. 2013;17(1):95-99. https://doi.org/10.4293/108680812X13517013317275 PMID:23743378 DOI: https://doi.org/10.4293/108680812X13517013317275
Pellegrino A, Damiani GR, Trio C, et al. Robotic shaving technique in 25 patients affected by deep infiltrating endometriosis of the rectovaginal space. J Minim Invasive Gynecol. 2015;22(7):1287-1292. https://doi.org/10.1016/j.jmig.2015.06.002 PMID:26070727 DOI: https://doi.org/10.1016/j.jmig.2015.06.002
Morelli L, Perutelli A, Palmeri M, et al. Robot-assisted surgery for the radical treatment of deep infiltrating endometriosis with colorectal involvement: short- and mid-term surgical and functional outcomes. Int J Colorectal Dis. 2016;31(3):643-652. https://doi.org/10.1007/s00384-015-2477-2 PMID:26686873 DOI: https://doi.org/10.1007/s00384-015-2477-2
Abo C, Roman H, Bridoux V, et al. Management of deep infiltrating endometriosis by laparoscopic route with robotic assistance: 3-year experience. J Gynecol Obstet Hum Reprod. 2017;46(1):9-18. https://doi.org/10.1016/j.jgyn.2015.12.003 PMID:28403962 DOI: https://doi.org/10.1016/j.jgyn.2015.12.003
Ercoli A, Bassi E, Ferrari S, et al. Robotic-assisted conservative excision of retrocervical-rectal deep infiltrating endometriosis: a case series. J Minim Invasive Gynecol. 2017;24(5):863-868. https://doi.org/10.1016/j.jmig.2017.03.011 PMID:28323223 DOI: https://doi.org/10.1016/j.jmig.2017.03.011
Collinet P, Leguevaque P, Neme RM, et al. Robot-assisted laparoscopy for deep infiltrating endometriosis: international multicentric retrospective study. Surg Endosc. 2014;28(8):2474-2479. https://doi.org/10.1007/s00464-014-3480-3 PMID:24609708 DOI: https://doi.org/10.1007/s00464-014-3480-3
Alboni C, Farulla A, Facchinetti F, Ercoli A. Robot-assisted nerve-sparing resection of bilateral parametrial deep infiltrating endometriosis. J Minim Invasive Gynecol. 2021;28(1):18-19. https://doi.org/10.1016/j.jmig.2020.05.009 PMID:32442484 DOI: https://doi.org/10.1016/j.jmig.2020.05.009
Kanno K, Andou M, Aiko K, et al. Robot-assisted nerve plane-sparing eradication of deep endometriosis with double-bipolar method. J Minim Invasive Gynecol. 2021;28(4):757-758. https://doi.org/10.1016/j.jmig.2020.07.018 PMID:32730992 DOI: https://doi.org/10.1016/j.jmig.2020.07.018
Levey KA. Use of fluorescence imaging technology to identify peritoneal endometriosis: a case report of new technology. Surg Laparosc Endosc Percutan Tech. 2014;24(2):e63-e65. https://doi.org/10.1097/SLE.0b013e31828fa28d PMID:24686365 DOI: https://doi.org/10.1097/SLE.0b013e31828fa28d
Ianieri MM, Della Corte L, Campolo F, et al. Indocyanine green in the surgical management of endometriosis: a systematic review. Acta Obstet Gynecol Scand. 2021;100(2):189-199. https://doi.org/10.1111/aogs.13971 PMID:32895911 DOI: https://doi.org/10.1111/aogs.13971
Jayakumaran J, Pavlovic Z, Fuhrich D, Wiercinski K, Buffington C, Caceres A. Robotic single-site endometriosis resection using near-infrared fluorescence imaging with indocyanine green: a prospective case series and review of literature. J Robot Surg. 2020;14(1):145-154. https://doi.org/10.1007/s11701-019-00951-0 PMID:30937836 DOI: https://doi.org/10.1007/s11701-019-00951-0
Cosentino F, Vizzielli G, Turco LC, et al. Near-infrared imaging with indocyanine green for detection of endometriosis lesions (Gre-Endo Trial): a pilot study. J Minim Invasive Gynecol. 2018;25(7):1249-1254. https://doi.org/10.1016/j.jmig.2018.02.023 PMID:29551477 DOI: https://doi.org/10.1016/j.jmig.2018.02.023
Vizzielli G, Cosentino F, Raimondo D, et al. Real three-dimensional approach vs two-dimensional camera with and without real-time near-infrared imaging with indocyanine green for detection of endometriosis: a case-control study. Acta Obstet Gynecol Scand. 2020;99(10):1330-1338. https://doi.org/10.1111/aogs.13866 PMID:32274789 DOI: https://doi.org/10.1111/aogs.13866
Tang NZ, Goldman TL, Prabakar C. Robotically-assisted laparoscopic resection of endometriosis using firefly technology. J Minim Invasive Gynecol. 2015;22(6S):S151. https://doi.org/10.1016/j.jmig.2015.08.552 PMID:27678851 DOI: https://doi.org/10.1016/j.jmig.2015.08.552
Guan X, Nguyen MTA, Walsh TM, Kelly B. Robotic single-site endometriosis resection using firefly technology. J Minim Invasive Gynecol. 2016;23(1):10-11. https://doi.org/10.1016/j.jmig.2015.08.001 PMID:26260298 DOI: https://doi.org/10.1016/j.jmig.2015.08.001
Bar-Shavit Y, Jaillet L, Chauvet P, Canis M, Bourdel N. Use of indocyanine green in endometriosis surgery. Fertil Steril. 2018;109(6):1136-1137. https://doi.org/10.1016/j.fertnstert.2018.02.113 PMID:29885885 DOI: https://doi.org/10.1016/j.fertnstert.2018.02.113
De Neef A, Cadière GB, Bourgeois P, Barbieux R, Dapri G, Fastrez M. Fluorescence of deep infiltrating endometriosis during laparoscopic surgery: a preliminary report on 6 cases. Surg Innov. 2018;25(5):450-454. https://doi.org/10.1177/1553350618785486 PMID:29998782 DOI: https://doi.org/10.1177/1553350618785486
Cela V, Papini F, Vacca C, et al. Clinical use of indocyanine green in bowel endometriosis surgery. J Minim Invasive Gynecol. 2021;28(7):1275-1276. https://doi.org/10.1016/j.jmig.2020.09.010 PMID:32966892 DOI: https://doi.org/10.1016/j.jmig.2020.09.010
Raimondo D, Borghese G, Mabrouk M, et al. Use of indocyanine green for intraoperative perfusion assessment in women with ureteral endometriosis: a preliminary study. J Minim Invasive Gynecol. 2021;28(1):42-49. https://doi.org/10.1016/j.jmig.2020.04.004 PMID:32283326 DOI: https://doi.org/10.1016/j.jmig.2020.04.004
Seracchioli R, Raimondo D, Arena A, Zanello M, Mabrouk M. Clinical use of endovenous indocyanine green during rectosigmoid segmental resection for endometriosis. Fertil Steril. 2018;109(6):1135. https://doi.org/10.1016/j.fertnstert.2018.02.122 PMID:29935649 DOI: https://doi.org/10.1016/j.fertnstert.2018.02.122
Malzoni M, Iuzzolino D, Rasile M, et al. Surgical principles of segmental rectosigmoid resection and reanastomosis for deep infiltrating endometriosis. J Minim Invasive Gynecol. 2020;27(2):258. https://doi.org/10.1016/j.jmig.2019.06.018 PMID:31325591 DOI: https://doi.org/10.1016/j.jmig.2019.06.018
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Copyright (c) 2023 Francesca Massimello, Attilio Di Spiezio Sardo, Giuseppe Bifulco, Stefano Angioni, Vito Cela
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2023-02-21
Published 2023-03-17