2012 Cochrane Review: Robotic assisted surgery for gynaecological cancer

Review:

Abstract

Background

Robotic surgery is the latest innovation in the field of minimally invasive surgery. Robotic surgical systems have been used to perform surgery for endometrial, cervical cancer and ovarian cancer. There is mounting evidence which demonstrates the feasibility and safety of robotic surgery for gynaecological oncology.

Objectives

To evaluate the evidence for and against robotic assisted surgery in gynaecological cancer.

Search methods

We searched the Cochrane Gynaecological Cancer Review Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 2), MEDLINE and EMBASE (up to July 2010) and citation lists of relevant publications.

Selection criteria

All randomised controlled trials (RCTs) comparing robotic assisted surgery for gynaecological cancer to laparoscopic or open surgical procedures as well as RCTs comparing different types of robotic assistants.

Data collection and analysis

Two review authors independently screened studies for inclusion. No RCTs were identified, therefore data collection and analysis could not be performed.

Main results

No studies were found that met the inclusion criteria. Controlled clinical trials (CCTs) are summarised and analysed, but are not discussed in the main body of the review as they present a high risk of bias.

Authors' conclusions

Well-designed RCTs are required as only low quality evidence from CCTs is available. These studies support the use of robotic assisted surgery for endometrial cancer and cervical cancer, but these findings present a high risk of bias.

 

Plain language summary

Robotic assisted surgery for gynaecological cancer

In recent years, robotic surgery or robot assisted surgery has been developed to support a range of surgical procedures. Robotic surgery in cervical and endometrial cancer is one of the fastest growing areas. Major advances aided by surgical robots are being made via remote surgery, keyhole (laparoscopic) surgery and unmanned surgery. It is hypothesised that robotic surgery may result in reduced blood loss, favourable complication rates and short hospital stays. However, the review authors found no RCTs to support or refute the use of robotic assisted surgery for gynaecological cancer. Evidence from controlled clinical trials offers very little credibility as these studies present a high risk of bias.